| Frequency of atrial septal aneurysms in patients with cerebral ischemic events. | |
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MedLine Citation:
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PMID: 10208995 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Atrial septal aneurysm (ASA) is a putative risk factor for cardioembolism. However, the frequency of ASA in the general population has not been adequately determined. Therefore, the frequency in patients with cerebral ischemic events, compared with the frequency in the general population, is poorly defined. We sought to determine the frequency of ASA in the general population and to compare the frequency of ASA in patients with cerebral ischemic events with the frequency in the general population. METHODS AND RESULTS: The frequency of ASA in the population was determined in 363 subjects, a sample of the participants in the Stroke Prevention: Assessment of Risk in a Community study (control subjects), and was compared with the frequency in 355 age- and sex-matched patients undergoing transesophageal echocardiography in search of a cardiac source of embolism after a focal cerebral ischemic event. The proportion with ASA was 7.9% in patients versus 2.2% in control subjects (P=0.002; odds ratio of ASA, 3.65; 95% CI, 1.64 to 8.13, in patients versus control subjects). Patent foramen ovale (PFO) was detected with contrast injections in 56% of subjects with ASA. The presence of ASA predicted the presence of PFO (odds ratio of PFO, 4.57; 95% CI, 2.18 to 9.57, in subjects with versus those without ASA). In 86% of subjects with ASA and cerebral ischemia, transesophageal echocardiography did not detect an alternative source of cardioembolism other than an associated PFO. CONCLUSIONS: The prevalence of ASA based on this population-based study is 2.2%. The frequency of ASA is relatively higher in patients evaluated with transesophageal echocardiography after a cerebral ischemic event. ASA is frequently associated with PFO, suggesting paradoxical embolism as a mechanism of cardioembolism. In patients with cerebral ischemia and ASA, ASA (with or without PFO) commonly is the only potential cardioembolic source detected with transesophageal echocardiography. |
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Authors:
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Y Agmon; B K Khandheria; I Meissner; F Gentile; J P Whisnant; J D Sicks; W M O'Fallon; J L Covalt; D O Wiebers; J B Seward |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Circulation Volume: 99 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 1999 Apr |
Date Detail:
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Created Date: 1999-04-30 Completed Date: 1999-04-30 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1942-4 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Brain Ischemia / epidemiology*, etiology Comorbidity Echocardiography, Transesophageal Female Heart Aneurysm / complications, epidemiology* Heart Atria Heart Diseases / complications, epidemiology Heart Septum* Humans Intracranial Embolism and Thrombosis / epidemiology*, etiology Male Middle Aged Minnesota / epidemiology Prevalence Risk Factors |
| Grant Support | |
ID/Acronym/Agency:
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NS-06663/NS/NINDS NIH HHS |
| Comments/Corrections | |
Comment In:
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Circulation. 2000 May 30;101(21):E210
[PMID:
10831538
]
Circulation. 2000 Jul 25;102(4):E27 [PMID: 10908225 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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