Perioperative Neurocognitive and Cardiovascular Disease

Perioperative neurocognitive disorder presents a significant challenge as a postoperative complication, particularly among elderly patients. Despite its prevalence, the precise etiology and underlying mechanisms remain elusive. This edition delves into the impact of cardiovascular disease (CVD) on postoperative cognitive function through three insightful articles. Jason Zhensheng Qu presents a comprehensive narrative review titled "Neuroprotection and Classification of Neurologic Dysfunction in Aortic Arch Surgery: A Narrative Review." Qu elucidates recent advancements in cerebral protection during aortic arch surgery, delving into the intricacies of defining neurologic dysfunction in this context. The review proposes a refined classification system for neurologic dysfunction, highlighting the potential for advanced imaging modalities such as positron emission tomography and MRI to serve as neurologic biomarkers. Qu emphasizes the necessity of a multidisciplinary approach in optimizing classification and treatment protocols. Nedim Çekmen and Begüm Nemika Gökdemir contribute a review titled "Anesthesia and Pulmonary Hypertension: A Narrative Review," focusing on perioperative management strategies for patients with pulmonary hypertension (PH). Their narrative explores preoperative preparation, monitoring, anesthesia, ventilator management, pain control, and preventive measures based on current literature. The review underscores the importance of multidisciplinary collaboration in formulating comprehensive care plans for PH patients, advocating for advanced intraoperative and postoperative monitoring, pulmonary vasodilator therapy, and tailored anesthesia and analgesia regimens. In "Cognitive Function in Atrial Fibrillation: A Narrative Review of Evidence and Mechanisms," Rakesh Agarwal et al. investigate the relationship between cognitive impairment and AF, highlighting associated mechanisms and therapeutic targets. The review establishes AF as a risk factor for cognitive decline, particularly following clinical stroke, prompting targeted risk management and treatment strategies for AF patients. In addition, three articles examine the interplay between CVD and brain function in diverse contexts. David McMillan et al. scrutinize the neurobehavioral changes associated with acute rheumatic fever and rheumatic heart disease, shedding light on the pathogenesis of conditions like Sydenham's chorea. Joana Brito et al. explore the cardiovascular implications of COVID-19 infection, emphasizing the bidirectional relationship between COVID-19 and preexisting cardiac conditions. Finally, Jamir Pitton Rissardo and Ana Leticia Fornari Caprara's article "Impact of Age on the Outcomes of Atrial Fibrillation-Related Stroke" underscores the influence of aging on the prognosis of AF-related stroke, advocating for further research in this domain. We extend sincere appreciation to all authors for their invaluable contributions. Our aim is to enrich our understanding of cardiovascular disorders and neurological function for our readership.