Characteristics of Patent Foramen Ovale: Analysis from a Single Center

Zhang, Bin; Li, Dong; Song, Anjian; Ren, Qiang; Cai, Shangan; Wang, Peng; Tan, Wenfeng; Zhang, Gaoxing; Guo, Jun

doi:10.1155/2022/5430598

Cited by 7 publications

(5 citation statements)

References 41 publications

(27 reference statements)

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“… 28 The higher prevalence of migraine among women is well known; among healthy young women, the prevalence varies between 18% and 33%, whereas it is <10% in young men. 30 , 31 Also, migraine prevalence has been consistently higher among patients with PFO, 32 and several studies have shown that migraine may have a close relationship with PFO. 33 …”

Section: Discussionmentioning

confidence: 99%

Sex Differences in Patients With Cryptogenic Cerebrovascular Events Undergoing Transcatheter Closure of Patent Foramen Ovale

Farjat‐Pasos,

Guedeney,

Houde

et al. 2023

JAHA

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Background Scarce data exist on sex differences in patients with cryptogenic cerebrovascular events undergoing patent foramen ovale (PFO) closure. This study aimed to determine the sex differences in clinical profile, procedural characteristics, and long‐term outcomes of patients with cryptogenic cerebrovascular events undergoing PFO closure. Methods and Results A retrospective cohort was used, including 1076 consecutive patients undergoing PFO closure because of a cryptogenic cerebrovascular event. Patients were divided into 2 groups: 469 (43.6%) women and 607 (56.4%) men. The median follow‐up was 3 years (interquartile range, 2–8 years). Women were younger (46±13 versus 50±12 years; P <0.01) and had a higher risk of paradoxical embolism score (6.9±1.7 versus 6.6±1.6; P <0.01). Procedural characteristics and postprocedural antithrombotic therapy were similar. At follow‐up, there were no differences in atrial fibrillation (women versus men: 0.47 versus 0.97 per 100 patient‐years; incidence rate ratio [IRR], 0.55 [95% CI, 0.27–1.11]; P =0.095; adjusted P =0.901), stroke (0.17 versus 0.07 per 100 patient‐years; IRR, 2.58 [95% CI, 0.47–14.1]; P =0.274; adjusted P =0.201), or transient ischemic attack (0.43 versus 0.18 per 100 patient‐years; IRR, 2.58 [95% CI, 0.88–7.54]; P =0.084; adjusted P =0.121); nevertheless, women exhibited a higher incidence of combined ischemic cerebrovascular events (0.61 versus 0.26 per 100 patient‐years; IRR, 2.58 [95% CI, 1.04–6.39]; P =0.041; adjusted P =0.028) and bleeding events (1.04 versus 0.45 per 100 patient‐years; IRR, 2.82 [95% CI, 1.41–5.65]; P =0.003; adjusted P =0.004). Conclusions Compared with men, women with cryptogenic cerebrovascular events undergoing PFO closure were younger and had a higher risk of paradoxical embolism score. After a median follow‐up of 3 years, there were no differences in stroke events, but women exhibited a higher rate of combined (stroke and transient ischemic attack) cerebrovascular events and bleeding complications. Additional studies are warranted to clarify sex‐related outcomes after PFO closure further.

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Section: Discussionmentioning

confidence: 99%

Sex Differences in Patients With Cryptogenic Cerebrovascular Events Undergoing Transcatheter Closure of Patent Foramen Ovale

Farjat‐Pasos,

Guedeney,

Houde

et al. 2023

JAHA

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“…A previous study have reported that PFO was associated with migraine(34%), stroke or TIA(25%), syncope(21%), chest tightness(37%), and palpitations(33%), with dizziness(63%) being the most symptom in the patients with PFO. [24] Activities increased right atrial pressure and worsened the right-to-left shunt, the symptoms of chest tightness aggravated after activities. The important clinical effect of a PFO is right-to-left shunting and the consequent potential for paradoxical embolism and arterial desaturation.…”

Section: Discussionmentioning

confidence: 99%

Machine learning model based on clinical features to diagnose unexplained dizziness with patent foramen ovale

Li,

Xiang,

Luo

et al. 2024

Preprint

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Objectives: Until recently, unexplained dizziness has received little attention. Clinicians have troubles to offer for the prevention and treatment of unexplained dizziness. This study aims to develop a machine learning model for diagnosing unexplained dizziness with patent foramen ovale and investigate key clinical features of this disorder. Methods: A cross-sectional, observational study of adults referred for unexplained dizziness enrolled from January 2019 to June 2023 at our tertiary hospital was undertaken. Subjects were split into dizziness with PFO group and non-PFO group. Demographic and clinical characteristics were collected. We randomly sampled data into training and validation sets by 7:3. LASSO regression was used to select the saliently important features in the training sets. Seven machine learning algorithms were used to develop a machine learning model for diagnosing unexplained dizziness with PFO. The area under the receiver operating characteristic curve (AUROC), the area under the precision-recall curve (AUPRC), accuracy, sensitivity, specificity, and F1-score were measured to evaluate the performance of models. The SHapley Additive exPlanations (SHAP) value was used to visualize the importance of key factors. Results:233 unexplained dizziness patients met the criteria for PFO,160 unexplained dizziness patients without PFO. Dizziness triggers and aggravating factors, recurrent episodes, chest tightness, amaurosis, palpitation, chronic persistent and age were selected according to LASSO regression in the training sets. Repeated cross-validation showed that the LGB model had the highest AUROC of 0.871(95%CI 0.86,0.882), AUPRC of 0.886(95%CI 0.878,0.894) among seven models. The model had high comprehensive performance and strong predictive power. SHAP analysis demonstrated the visual interpretation of the optimal model and revealed how the interaction of age and other features in the model affected the diagnosis of PFO. Conclusions: The LGB diagnosing model could effectively and reliably diagnose unexplained dizziness with PFO. SHAP analysis could improve the visual interpretation of machine learning models and help physicians better understand how the features affect outcomes.

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“…22 Regarding echocardiographic findings, one had a diagnosis of IAC type ostium secundum with left-toright flow, considered a non-critical CHD, and seven had a report of PFO, four of which had PFO with flow from left to right, and three PFO with bidirectional flow, considered a physiological state, as under usual circumstances it closes in the first year of life. 23 These changes, when assigned a grade under the Allan and Huggon parameter, which range from 1 to 10, with 1 being the best prognosis and 10 being the worst, are classified with a grade of 2, making it possible to predict a good prognosis and low rates of morbidity and mortality in the long run. 9 PFO was also the most common finding by Carvelo et al, 24 in an analysis of positive pulse oximetry tests, totaling 40%, followed by IAC (5.7%), PFO + IAC (3.8 %), patent ductus arteriosus (3.8%), FOP + pulmonary hypertension (1.9%), FOP + patent ductus arteriosus + pulmonary hypertension (1.9%), FOP + aortic hypoplasia (1.9% ).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Critical Congenital Heart Disease Detected in the Pulse Oximetry Test in Asymptomatic Newborns, ≥35 Gestational Weeks, in a Maternity in Southern Brazil

Witkowski,

Torres,

Pereira

et al. 2024

International Journal of Cardiovascular Sciences

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Background: Congenital heart diseases (CHD) are one of the most prevalent malformations, and the screening tests to identify critical congenital heart disease (CCHD) is the pulse oximetry test, with subsequent investigation and treatment.Objective: To quantify positive pulse oximetry tests and verify the prevalence of CCHD detected by it in asymptomatic newborns, ≥35 gestational weeks, in a Brazilian maternity hospital.Methodology: This is an observational, retrospective, quantitative, analytical and cross-sectional study, conducted from October 2020 to May 2022, in a maternity hospital in southern Brazil, through the collection of records of positive oximetry pulse tests, following the norms of screening CCHD test of the Brazilian Society of Pediatrics (SBP), after they were evaluated with echocardiography for confirmation or exclusion of CHD.Results: A total of 5,667 newborns were evaluated in this study, according to the inclusion criteria; 0.17% (n = 10) had a positive pulse oximetry test. Regarding the results of the echocardiography of the neonates with a positive test, two were normal, seven were cases of patent foramen ovale (PFO), and one was a case (0,017%) with interatrial communication (IAC) diagnosis. In the same period, five neonates with CCHD were born, symptomatic, diagnosed by physical examination, and referred to neonatal intensive care units (NICU) before taking the neonatal cardiac screening (< 24 hours of life). Conclusion:The prevalence of positive pulse oximetry tests was 0.17% and none CCHD was detected. Five cases of CCHD were born in this period, but they were diagnosed before the recommend time to perform the screening test.

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Characteristics of Patent Foramen Ovale: Analysis from a Single Center

Cited by 7 publications

References 41 publications

Sex Differences in Patients With Cryptogenic Cerebrovascular Events Undergoing Transcatheter Closure of Patent Foramen Ovale

Sex Differences in Patients With Cryptogenic Cerebrovascular Events Undergoing Transcatheter Closure of Patent Foramen Ovale

Machine learning model based on clinical features to diagnose unexplained dizziness with patent foramen ovale

Prevalence of Critical Congenital Heart Disease Detected in the Pulse Oximetry Test in Asymptomatic Newborns, ≥35 Gestational Weeks, in a Maternity in Southern Brazil

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