Patent Foramen Ovale Size and Embolic Brain Imaging Findings Among Patients With Ischemic Stroke

Author:

Steiner Michaela M.1,Di Tullio Marco R.1,Rundek Tanja1,Gan Robert1,Chen Xun1,Liguori Chiara1,Brainin Michael1,Homma Shunichi1,Sacco Ralph L.1

Affiliation:

1. From the Neurological Institute (M.M.S., T.R., R.G., X.C., R.L.S.) and the Division of Cardiology, Department of Medicine (M.R. Di T., C.L., S.H.), Columbia-Presbyterian Medical Center, New York, NY; Division of Biostatistics (X.C.) and Division of Epidemiology and Gertrude H. Sergievsky Center (R.L.S.), School of Public Health, Columbia University, New York, NY; and Center for Postgraduate Studies in Neuroscience, Danube University, Landesnervenklinik Gugging (M.M.S., M.B.), Gugging, Austria.

Abstract

Background and Purpose —Although the cause of stroke among patients with patent foramen ovale (PFO) may be due to paradoxical cerebral embolism (PCE), this mechanism is often difficult to prove. The aim of our study was to evaluate the association between brain imaging findings suggestive of embolism and PFO among ischemic stroke patients. Methods —As part of the Northern Manhattan Stroke Study, 95 patients with first ischemic stroke over age 39 underwent transesophageal echocardiography (TEE) for evaluation of a cardiac source of embolism. The stroke subtype was determined by modified NINDS Stroke Data Bank criteria. Stroke subtype and MRI/CT imaging data were evaluated blind to the presence of a PFO. These findings were compared between two groups: patients with medium to large PFO (≥2 mm) and small (<2 mm) or no PFO. Results —Of the 95 patients who underwent TEE, 31 (33%) had a PFO. The frequency of PFO was significantly greater among patients with cryptogenic infarcts (19 of 42; 45%) compared with patients with determined cause of stroke (12 of 53, 23%; P =0.02). Medium to large PFOs were found more often among cryptogenic strokes than among infarcts of determined cause (26% versus 6%; P =0.04). Superficial infarcts occurred more often in the group with larger PFOs than in the group with small or no PFOs (50% versus 21%; P =0.02). Patients with medium or large PFOs more frequently had occipital and infratentorial strokes (57% versus 27%; P =0.02). Conclusions —Stroke patients with larger PFOs show more brain imaging features of embolic infarcts than those with small PFOs. Larger PFOs may be more likely to cause paradoxical embolization and may help explain the stroke mechanism among patients with no other definite cause.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialised Nursing,Cardiology and Cardiovascular Medicine,Clinical Neurology

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3