Patent Foramen Ovale and the Risk of Ischemic Stroke in a Multiethnic Population

Tullio, Marco R. Di; Sacco, Ralph L.; Sciacca, Robert R.; Jin, Zhezhen; Homma, Shunichi

doi:10.1016/j.jacc.2006.08.063

Cited by 291 publications

(212 citation statements)

References 47 publications

(39 reference statements)

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“…Diameter was assessed as the maximum separation between the septum primum and septum secundum on TEE, so their results are not directly comparable to balloon stretch diameter. Two population-based studies have reported that isolated ASA was an independent risk factor for cerebrovascular events [15,16]. Meissner et al [15] reported that risk of cerebrovascular events was greater in subjects with ASA (hazard ratio 3.72, 95% CI 0.88-15.71).…”

Section: =04 P=05)mentioning

confidence: 99%

“…Characteristics of the interatrial septum in patients with PFO, particularly coexisting atrial septal aneurysm (ASA), have been implicated in increased risk of stroke [14][15][16] and in migraine with aura [17]. In a case-control study using transoesophageal echocardiography (TEE) [18], a PFO measuring >4 mm in diameter was associated with higher risk for stroke or transient ischaemic attack (TIA).…”

Section: Introductionmentioning

confidence: 99%

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Migraineurs with patent foramen ovale have larger right-to-left shunt despite similar atrial septal characteristics

et al. 2007

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The objective of the study was to assess differences in proportion of large right-to-left shunt (RLS) and atrial septal characteristics between migraineurs and non-migraineurs referred for transcatheter closure of patent foramen ovale (PF0). This retrospective study took place in a large metropolitan medical centre. The patients were migraineurs with aura (n=52), migraineurs without aura (n=19) and non-migraineurs (n=149). RLS was evaluated before closure using bilateral power m-mode transcranial Doppler at rest and after calibrated, sustained Valsalva manoeuvre, and graded with a validated 0-5 scale. Intracardiac echocardiography was used to assess atrial septal characteristics. Migraineurs had a higher proportion of large RLS (Grade IV or V) than nonmigraineurs at rest and after calibrated Valsalva (rest, p=0.04; Valsalva, p=0.01). Atrial septal characteristics were similar between groups. Migraine is associated with larger RLS at rest and strain; however migraine status does not predict PFO characteristics.

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Section: =04 P=05)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Migraineurs with patent foramen ovale have larger right-to-left shunt despite similar atrial septal characteristics

et al. 2007

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“…Looking at non-anesthesia-related evidence, up to 40% of strokes are considered cryptogenic, meaning no identifiable cause can be found. 3 Of those cryptogenic strokes, 42% have a patent foramen ovale (functionally similar to ASD in shunt dynamics), up to 50% in young patients. 4 In terms of relative likelihood, this potential of right to left movement is not simply an academic matter, but a potential that occurs during every single beat of the heart.…”

Section: Anesthetic Managementmentioning

confidence: 99%

ASD and VSD Flow Dynamics and Anesthetic Management

Yen¹

2015

Anesthesia Progress

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Atrial septal defects and ventricular septal defects are often encountered in patients presenting for treatment under anesthesia. The flow mechanisms for both defects are predominantly left to right shunting prior to long-term maladaptive changes that may occur. Close examination of the shunt dynamics demonstrates a minor right to left shunt that occurs as well. The article discusses these dynamics and the impact on an anesthetic plan.

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“…Традиционно в работах кардиоло-гов высказывается мнение, что ООО (ввиду неболь-шой площади и наличия клапана) не приводит к расстройствам гемодинамики и потому часто трак-туется как «гемодинамически незначимое» [16]. Тем не менее проведенные в последнее время исследова-ния убедительно доказывают, что наличие ООО ча-сто сопровождается парадоксальной микроэмболи-ей с клиническими проявлениями в виде транзитор-ных ишемических атак (ТИА), инсультов (в том числе немых), мигрени с аурой и эпизодов транзи-торной глобальной амнезии [17].…”

Section: патология сердцаunclassified

New risk factors of stroke in young adults

Yevtushenko

Filimonov

Yevtushenko

2015

Z. nevrol. psikhiatr. im. S.S. Korsakova

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Gorky Donetsk national medical universityСогласно современным представлениям, до 75% случаев развития инсульта в общей популяции можно связать с действием общепринятых (базисных) факторов риска, таких как артериальная гипертензия, атеросклероз, нарушения ритма сердца, сахарный диабет. тем не менее до 25% случаев инсульта связано с воздействием иных факторов риска, особенно у лиц молодого возраста. в настоящем обзоре даны анализ и оценка наиболее значимых новых факторов риска развития инсульта у лиц молодого возраста, таких как генетическая предрасположенность, болезнь малых сосудов, гипергомоцистеинемия, тромбофилии, наличие «немых» инфарктов мозга и др. Акцентировано внимание на роли новых факторов риска развития инсульта у женщин. на основании современных данных литературы и личных наблюдений приводятся модифицированные критерии клинической оценки новых факторов риска. обоснован паттерн лабораторных исследований, направленных на оценку риска развития инсульта. ключевые слова: инсульт, новые факторы риска, молодой возраст.According to the modern point of view, up to 75% stroke cases may be associated with conventional (basic) risk factors such as hypertension, atherosclerosis, cardiac arrhythmia, diabetes, and others. however, up to 25% of stroke cases are associated with the influence of other risk factors, especially among young people. in this review, an analysis and evaluation of the most significant new stroke risk factors in young adults, such as genetic predisposition, «small» vessels disease, hyperhomocysteinemia, thrombophilia, «silent» brain infarction and others was made. Attention was paid to a role of new stroke risk factors in women. in this review, criteria for clinical evaluation of new stroke risk factors and pattern of laboratory tests to determine the stroke risk were defined based on current literature and personal observations. keywords: stroke, new risk factors, young age.

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Patent Foramen Ovale and the Risk of Ischemic Stroke in a Multiethnic Population

Abstract: Patent foramen ovale, alone or together with ASA, was not associated with an increased stroke risk in this multiethnic cohort. The independent role of ASA needs further assessment in appositely designed and powered studies.

Cited by 291 publications

References 47 publications

Migraineurs with patent foramen ovale have larger right-to-left shunt despite similar atrial septal characteristics

Migraineurs with patent foramen ovale have larger right-to-left shunt despite similar atrial septal characteristics

ASD and VSD Flow Dynamics and Anesthetic Management

New risk factors of stroke in young adults

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