Document Detail


Patent foramen ovale with atrial septal aneurysm may contribute to white matter lesions in stroke patients.
MedLine Citation:
PMID:  20424440     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of the present study was to assess the contribution of embolic etiologies, patent foramen ovale (PFO) and atrial septal aneurysm (ASA), to cerebral white matter lesions (WMLs) in ischemic stroke patients. METHODS: Patients with acute ischemic stroke who underwent transesophageal echocardiography were prospectively studied to investigate the relationships between the prevalence of PFO and ASA and the degree of WMLs. The patients were classified into four groups based on transesophageal echocardiography findings: (1) the PFO group (patients having PFO but not ASA); (2) the ASA group (patients having ASA but not PFO); (3) the PFO-ASA group (patients having both PFO and ASA), and (4) the non-septal abnormalities group (non-SA group, patients with neither PFO nor ASA). Based on MRI findings, the patients were also subdivided into grades 0, 1, 2, and 3 according to the Fazekas classification. RESULTS: 115 patients (age, 69 +/- 11 years; 41 females) were enrolled; 49 (43%) were in the PFO group, 4 (3%) were in the ASA group, 23 (20%) were in the PFO-ASA group, and 39 (34%) were in the non-SA group. The PFO-ASA group had significantly increased WMLs compared to the other three groups (p = 0.004). On multiple logistic regression analysis, the coexistence of PFO and ASA was significantly associated with the degree of WMLs (odds ratio: 2.40; 95% confidence interval: 1.11-5.17; p = 0.026) when the PFO-ASA and non-SA groups were compared. CONCLUSIONS: The coexistence of PFO with ASA could play an important pathogenic role in WML severity.
Authors:
Yuji Ueno; Yoshiaki Shimada; Ryota Tanaka; Nobukazu Miyamoto; Yasutaka Tanaka; Nobutaka Hattori; Takao Urabe
Publication Detail:
Type:  Journal Article     Date:  2010-04-27
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  30     ISSN:  1421-9786     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2010  
Date Detail:
Created Date:  2010-06-09     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  15-22     Citation Subset:  IM    
Copyright Information:
Copyright 2010 S. Karger AG, Basel.
Affiliation:
Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Brain / pathology*
Brain Ischemia / etiology*,  pathology
Cerebral Angiography / methods
Chi-Square Distribution
Echocardiography, Transesophageal
Female
Foramen Ovale, Patent / complications*,  ultrasonography
Heart Aneurysm / complications*,  ultrasonography
Heart Septal Defects, Atrial / complications*,  ultrasonography
Humans
Logistic Models
Magnetic Resonance Angiography
Male
Middle Aged
Odds Ratio
Prospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Stroke / etiology*,  pathology

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