| Title: |
Factors associated with shunt dynamic in patients with cryptogenic stroke and patent foramen ovale: an observational cohort study |
| Authors: |
Allendörfer Jens; Sieweke Nicole; Grebe Mathias; Puille Maximilian; Tanislav Christian; Pabst Wolfgang; Kaps Manfred; Reichenberger Frank |
| Source: |
BMC Cardiovascular Disorders, Vol 11, Iss 1, p 54 (2011) |
| Publisher Information: |
BMC |
| Publication Year: |
2011 |
| Collection: |
Directory of Open Access Journals: DOAJ Articles |
| Subject Terms: |
Diseases of the circulatory (Cardiovascular) system; RC666-701 |
| Description: |
Background As previously reported there is evidence for a reduction in right to left shunt (RLS) in stroke patients with patent foramen ovale (PFO). This occurs predominantly in patients with cryptogenic stroke (CS). We therefore analysed factors associated with a shunt reduction on follow-up in stroke patients suffering of CS. Methods On index event PFO and RLS were proven by transesophageal echocardiography and contrast-enhanced transcranial Doppler-sonography (ce-TCD). Silent PE was proved by ventilation perfusion scintigraphy (V/Q) within the stroke work-up on index event; all scans were re-evaluated in a blinded manner by two experts. The RLS was re-assessed on follow-up by ce-TCD. A reduction in shunt volume was defined as a difference of ≥20 microembolic signals (MES) or the lack of evidence of RLS on follow-up. For subsequent analyses patients with CS were considered; parameters such as deep vein thrombosis (DVT) and silent pulmonary embolism (PE) were analysed. Results In 39 PFO patients suffering of a CS the RLS was re-assessed on follow-up. In all patients (n = 39) with CS a V/Q was performed; the median age was 40 years, 24 (61.5%) patients were female. In 27 patients a reduction in RLS was evident. Silent PE was evident in 18/39 patients (46.2%). Factors such as atrial septum aneurysm, DVT or even silent PE were not associated with RLS dynamics. A greater time delay from index event to follow-up assessment was associated with a decrease in shunt volume (median 12 vs. 6 months, p = 0.013). Conclusions In patients with CS a reduction in RLS is not associated with the presence of a venous embolic event such as DVT or silent PE. A greater time delay between the initial and the follow-up investigation increases the likelihood for the detection of a reduction in RLS. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
http://www.biomedcentral.com/1471-2261/11/54; https://doaj.org/toc/1471-2261; https://doaj.org/article/732d77abd7f742cd88a3213d1daa1a31 |
| DOI: |
10.1186/1471-2261-11-54 |
| Availability: |
https://doi.org/10.1186/1471-2261-11-54; https://doaj.org/article/732d77abd7f742cd88a3213d1daa1a31 |
| Accession Number: |
edsbas.3F1785E4 |
| Database: |
BASE |