Document Detail


Left atrial dysfunction in patients with patent foramen ovale and atrial septal aneurysm scheduled for transcatheter closure may play a role in aura genesis.
MedLine Citation:
PMID:  20624202     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It has been suggested that a left atrial (LA) dysfunction induced by large shunt and large atrial septal aneurysm (ASA) may act as a concurrent mechanism of arterial embolism in patients with patent foramen ovale (PFO) and prior stroke. We aimed to evaluate the potential contribution of this mechanism as trigger of migraine in patients with PFO.
METHODS: From January 2007 to September 2009, we prospectively enrolled subjects with migraine who underwent percutaneous PFO closure. Echocardiographic parameter of LA dysfunction was evaluated: pre- and postoperative values were compared to values of different sex and heart rate matched populations: 30 healthy patients, 21 migraine patients without PFO (MwoPFO), and a group of 25 PFO patients without migraine (PFOwoM). The Migraine Disability Assessment Score (MIDAS) was used to assess the incidence and severity of migraine.
RESULTS: Forty-five patients (38 females, mean age 38 +/- 6.7 years, mean MIDAS 35.8 +/- 4.7, and 28 patients with migraine with aura) fulfilled the inclusion criteria. After successful percutaneous closure (mean follow-up of 18.2 +/- 4.8 months), PFO closure remained complete in 95%; 35 of 45 patients reported resolution or amelioration of migraine (mean MIDAS score 12.3 +/- 8.8, P < 0.03). All patients with aura reported aura resolution. Preclosure values demonstrated significantly greater LA dysfunction, when compared with healthy and MwoPFO groups. Among patients in the study group, only patients with migraine with aura showed LA dysfunction comparable to PFOwoM patients.
CONCLUSION: This study suggests that LA dysfunction probably does not contribute to migraine itself but may play a role in the genesis of aura symptoms.
Authors:
Gianluca Rigatelli; Fabio Dell'avvocata; Paolo Cardaioli; Federico Ronco; Massimo Giordan; Gabriele Braggion; Silvio Aggio; Mauro Chinaglia; Jack P Cheng; Aravinda Nanjundappa
Publication Detail:
Type:  Journal Article     Date:  2010-07-06
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  23     ISSN:  1540-8183     ISO Abbreviation:  J Interv Cardiol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-19     Completed Date:  2010-12-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  370-6     Citation Subset:  IM    
Affiliation:
Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy. jackyheart@libero.it
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Atrial Function, Left / physiology*
Case-Control Studies
Female
Foramen Ovale, Patent / physiopathology*,  surgery
Heart Aneurysm / physiopathology*,  surgery
Heart Atria / physiopathology
Humans
Male
Migraine with Aura / physiopathology*
Prospective Studies
Septal Occluder Device

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Six- and twelve-month clinical outcomes after implantation of prokinetic BMS in patients with acute ...
Next Document:  Coronary left main and non-left main bifurcation angles: how are the angles modified by different bi...