Characteristics and prognosis of patients with cryptogenic stroke and suggestive of patent foramen ovale

Cardiovascular Ultrasound

Jaehuk Choi¹  Seonghoon Choi²  Min-Kyung Kang²  Dong Geum Shin²  Namho Lee²  Donghoon Han²  Jung Rae Cho²  Jin-Sun Jun³ 

[1] Division of Cardiology, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Seoul, South Korea;Division of Cardiology, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, South Korea;Division of Neurology, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, South Korea;

关键词: Cryptogenic stroke;    Patent foramen ovale;    Agitated saline echocardiography;   

DOI  :  10.1186/s12947-021-00255-0

来源: Springer

【 摘 要 】

AimsThe purpose of this study were to identify the usefulness of screening for PFO using agitated saline echocardiography (ASE) and characteristics and prognosis of patients with suggestive of patent foramen ovale (PFO).MethodsThree hundred three patients (mean age, 53 ± 9 years; 199 [66%] men) admitted with acute stroke or suspicion of stroke were included. Patients were classified into those with and without right-to-left shunt (RLS) according to the ASE results (positive ASE [n = 92] vs. negative ASE [n = 211]). Fifty-one out of ninety-two patients with positive ASE and twenty-one out of two hundred eleven patients with negative ASE underwent TEE with ASE to confirm PFO.ResultsNinety-two were positive for ASE and thirty-six of the fifty-one patients who underwent TEE were confirmed as having PFO. Of the patients with RLS grade 1, 50% were diagnosed with PFO and all patients with RLS grade ≥ 2 were diagnosed with PFO. All patients with negative ASE had no PFO (sensitivity of 100% and specificity of 58%). Patients with positive ASE were younger, had a lower body mass, and a lower prevalence of hypertension. The positive ASE patients had a higher mean Sʹ velocity and better diastolic function. Four of ninety-one patients with positive ASE and thirteen of one hundred seventy-seven showed recurrence of stroke and suspicion of stroke.ConclusionTransthoracic ASE is a good method to screen for PFO. Patients with suggestive of PFO had lower risk factors, less atherosclerosis, and better cardiac performance.

【 授权许可】

CC BY