Comparison of Frequencies of Patent Foramen Ovale and Thoracic Aortic Atherosclerosis in Patients With Cryptogenic Ischemic Stroke Undergoing Transesophageal Echocardiography
Studies have shown an association between the presence of a patent foramen ovale (PFO) and cryptogenic stroke (CS) in patients aged
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| Veröffentlicht in: | The American journal of cardiology 2011-12, Vol.108 (12), p.1815-1819 |
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| container_title | The American journal of cardiology |
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| creator | Gu, Xiaoyan, MD He, Yihua, MD Li, Zhian, MD Kontos, Michael C., MD Paulsen, Walter H.J., MD Arrowood, James A., MD Nixon, J.V. (Ian), MD |
| description | Studies have shown an association between the presence of a patent foramen ovale (PFO) and cryptogenic stroke (CS) in patients aged |
| doi_str_mv | 10.1016/j.amjcard.2011.07.058 |
| format | Article |
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(Ian), MD</creator><creatorcontrib>Gu, Xiaoyan, MD ; He, Yihua, MD ; Li, Zhian, MD ; Kontos, Michael C., MD ; Paulsen, Walter H.J., MD ; Arrowood, James A., MD ; Nixon, J.V. (Ian), MD</creatorcontrib><description>Studies have shown an association between the presence of a patent foramen ovale (PFO) and cryptogenic stroke (CS) in patients aged <55 years. In addition, protruding atheromatous plaques in the ascending aorta and aortic arch are an independent risk factor for ischemic stroke in patients aged ≥55 years. The aim of this study was to determine the association of CS in the 2 age groups with PFO and with atheromatous plaques in the ascending aorta and in the aortic arch. Transesophageal echocardiograms in 229 patients evaluated for CS were compared to those in 314 patients evaluated for cardiac disease other than PFO with no histories of stroke (the control group). The prevalence of PFO and the presence of complex atheromatous plaques in the ascending aorta and aortic arch were determined in all patients and compared between the CS and control patients in the 2 age groups. The prevalence of PFO was significantly higher in patients with CS than in control patients among those aged <55 years (31 of 114 [27%] vs 24 of 171 [14%], p = 0.006) and those aged ≥55 years (28 of 115 [24%] vs 21 of 143 [15%], p = 0.049). The incidence of atrial septal aneurysm was similar in the 2 groups irrespective of patient age, as was the prevalence of complex atheromatous plaques. Multivariate analysis showed that PFO was independently associated with CS, irrespective of patient age (<55 years: odds ratio 2.4, 95% confidence interval 1.3 to 4.5, p = 0.01; ≥55 years: odds ratio 1.9, 95% confidence interval 1.1 to 3.5, p = 0.03). In conclusion, PFO was significantly associated with CS in younger (aged <55 years) and older (aged ≥55 years) patients. Atrial septal aneurysm and complex atheromas in the ascending aorta and aortic arch do not appear to be associated with CS.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2011.07.058</identifier><identifier>PMID: 21889761</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aorta, Thoracic ; Aortic Diseases - complications ; Aortic Diseases - diagnostic imaging ; Atherosclerosis ; Atherosclerosis (general aspects, experimental research) ; Atherosclerosis - complications ; Atherosclerosis - diagnostic imaging ; Biological and medical sciences ; Blood and lymphatic vessels ; Brain Ischemia - complications ; Brain Ischemia - diagnostic imaging ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular system ; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava ; Echocardiography, Transesophageal ; Female ; Foramen Ovale, Patent - complications ; Foramen Ovale, Patent - diagnostic imaging ; Heart ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Ischemia ; Male ; Medical sciences ; Neurology ; Retrospective Studies ; Risk factors ; Stroke ; Stroke - complications ; Stroke - diagnostic imaging ; Ultrasonic imaging ; Ultrasonic investigative techniques ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>The American journal of cardiology, 2011-12, Vol.108 (12), p.1815-1819</ispartof><rights>2011</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011. Published by Elsevier Inc.</rights><rights>Copyright Elsevier Sequoia S.A. Dec 15, 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c391t-e6a7a8a0535a2a3d33b2ae411b9e869a614c1928e34750e348997d4859b566053</citedby><cites>FETCH-LOGICAL-c391t-e6a7a8a0535a2a3d33b2ae411b9e869a614c1928e34750e348997d4859b566053</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914911024404$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25340051$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21889761$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gu, Xiaoyan, MD</creatorcontrib><creatorcontrib>He, Yihua, MD</creatorcontrib><creatorcontrib>Li, Zhian, MD</creatorcontrib><creatorcontrib>Kontos, Michael C., MD</creatorcontrib><creatorcontrib>Paulsen, Walter H.J., MD</creatorcontrib><creatorcontrib>Arrowood, James A., MD</creatorcontrib><creatorcontrib>Nixon, J.V. (Ian), MD</creatorcontrib><title>Comparison of Frequencies of Patent Foramen Ovale and Thoracic Aortic Atherosclerosis in Patients With Cryptogenic Ischemic Stroke Undergoing Transesophageal Echocardiography</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Studies have shown an association between the presence of a patent foramen ovale (PFO) and cryptogenic stroke (CS) in patients aged <55 years. In addition, protruding atheromatous plaques in the ascending aorta and aortic arch are an independent risk factor for ischemic stroke in patients aged ≥55 years. The aim of this study was to determine the association of CS in the 2 age groups with PFO and with atheromatous plaques in the ascending aorta and in the aortic arch. Transesophageal echocardiograms in 229 patients evaluated for CS were compared to those in 314 patients evaluated for cardiac disease other than PFO with no histories of stroke (the control group). The prevalence of PFO and the presence of complex atheromatous plaques in the ascending aorta and aortic arch were determined in all patients and compared between the CS and control patients in the 2 age groups. The prevalence of PFO was significantly higher in patients with CS than in control patients among those aged <55 years (31 of 114 [27%] vs 24 of 171 [14%], p = 0.006) and those aged ≥55 years (28 of 115 [24%] vs 21 of 143 [15%], p = 0.049). The incidence of atrial septal aneurysm was similar in the 2 groups irrespective of patient age, as was the prevalence of complex atheromatous plaques. Multivariate analysis showed that PFO was independently associated with CS, irrespective of patient age (<55 years: odds ratio 2.4, 95% confidence interval 1.3 to 4.5, p = 0.01; ≥55 years: odds ratio 1.9, 95% confidence interval 1.1 to 3.5, p = 0.03). In conclusion, PFO was significantly associated with CS in younger (aged <55 years) and older (aged ≥55 years) patients. Atrial septal aneurysm and complex atheromas in the ascending aorta and aortic arch do not appear to be associated with CS.</description><subject>Adult</subject><subject>Aorta, Thoracic</subject><subject>Aortic Diseases - complications</subject><subject>Aortic Diseases - diagnostic imaging</subject><subject>Atherosclerosis</subject><subject>Atherosclerosis (general aspects, experimental research)</subject><subject>Atherosclerosis - complications</subject><subject>Atherosclerosis - diagnostic imaging</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Brain Ischemia - complications</subject><subject>Brain Ischemia - diagnostic imaging</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular system</subject><subject>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</subject><subject>Echocardiography, Transesophageal</subject><subject>Female</subject><subject>Foramen Ovale, Patent - complications</subject><subject>Foramen Ovale, Patent - diagnostic imaging</subject><subject>Heart</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Ischemia</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neurology</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Stroke</subject><subject>Stroke - complications</subject><subject>Stroke - diagnostic imaging</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonic investigative techniques</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkt1qGzEQhZfS0rhpH6FFFEqv1tXsr3TTEkzcBgIpxKGXYqwde-XsShtpHfBL9RmrxW4KuemNpBHfGUbnKEneA58Dh-rLbo79TqNv5hkHmPN6zkvxIpmBqGUKEvKXyYxznqUSCnmWvAlhF0uAsnqdnGUghKwrmCW_F64f0JvgLHMbtvT0sCerDYWp_Ikj2ZEtnceeLLt5xI4Y2oat2niljWYXzo_TNrbkXdDdtJrAjJ20JooD-2XGli38YRjdlmyEr4JuqY-H29G7e2J3tiG_dcZu2cqjDRTc0OKWsGOXunXTI43behzaw9vk1Qa7QO9O-3lyt7xcLX6k1zffrxYX16nOJYwpVVijQF7mJWaYN3m-zpAKgLUkUUmsoNAgM0F5UZc8rkLKuilEKddlVUXZefL52HfwLhoSRtWboKnr0JLbByW54MCLLI_kx2fkzu29jcNFqJZcVrmIUHmEdLQneNqowZse_UEBV1OcaqdOcaopTsVrFeOMug-n5vt1T82T6m9-Efh0AjBo7DbRPm3CP67MC87Lift25Cia9mjIqxAztpoa40mPqnHmv6N8fdZBdyamid09HSg8PRpUyBRXt9Pfm74eAM-Kghf5Hx3m13s</recordid><startdate>20111215</startdate><enddate>20111215</enddate><creator>Gu, Xiaoyan, MD</creator><creator>He, Yihua, MD</creator><creator>Li, Zhian, MD</creator><creator>Kontos, Michael C., MD</creator><creator>Paulsen, Walter H.J., MD</creator><creator>Arrowood, James A., MD</creator><creator>Nixon, J.V. (Ian), MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20111215</creationdate><title>Comparison of Frequencies of Patent Foramen Ovale and Thoracic Aortic Atherosclerosis in Patients With Cryptogenic Ischemic Stroke Undergoing Transesophageal Echocardiography</title><author>Gu, Xiaoyan, MD ; He, Yihua, MD ; Li, Zhian, MD ; Kontos, Michael C., MD ; Paulsen, Walter H.J., MD ; Arrowood, James A., MD ; Nixon, J.V. 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Malformations of the aorta, pulmonary vessels and vena cava</topic><topic>Echocardiography, Transesophageal</topic><topic>Female</topic><topic>Foramen Ovale, Patent - complications</topic><topic>Foramen Ovale, Patent - diagnostic imaging</topic><topic>Heart</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Ischemia</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neurology</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Stroke</topic><topic>Stroke - complications</topic><topic>Stroke - diagnostic imaging</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonic investigative techniques</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gu, Xiaoyan, MD</creatorcontrib><creatorcontrib>He, Yihua, MD</creatorcontrib><creatorcontrib>Li, Zhian, MD</creatorcontrib><creatorcontrib>Kontos, Michael C., MD</creatorcontrib><creatorcontrib>Paulsen, Walter H.J., MD</creatorcontrib><creatorcontrib>Arrowood, James A., MD</creatorcontrib><creatorcontrib>Nixon, J.V. (Ian), MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gu, Xiaoyan, MD</au><au>He, Yihua, MD</au><au>Li, Zhian, MD</au><au>Kontos, Michael C., MD</au><au>Paulsen, Walter H.J., MD</au><au>Arrowood, James A., MD</au><au>Nixon, J.V. (Ian), MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of Frequencies of Patent Foramen Ovale and Thoracic Aortic Atherosclerosis in Patients With Cryptogenic Ischemic Stroke Undergoing Transesophageal Echocardiography</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2011-12-15</date><risdate>2011</risdate><volume>108</volume><issue>12</issue><spage>1815</spage><epage>1819</epage><pages>1815-1819</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Studies have shown an association between the presence of a patent foramen ovale (PFO) and cryptogenic stroke (CS) in patients aged <55 years. In addition, protruding atheromatous plaques in the ascending aorta and aortic arch are an independent risk factor for ischemic stroke in patients aged ≥55 years. The aim of this study was to determine the association of CS in the 2 age groups with PFO and with atheromatous plaques in the ascending aorta and in the aortic arch. Transesophageal echocardiograms in 229 patients evaluated for CS were compared to those in 314 patients evaluated for cardiac disease other than PFO with no histories of stroke (the control group). The prevalence of PFO and the presence of complex atheromatous plaques in the ascending aorta and aortic arch were determined in all patients and compared between the CS and control patients in the 2 age groups. The prevalence of PFO was significantly higher in patients with CS than in control patients among those aged <55 years (31 of 114 [27%] vs 24 of 171 [14%], p = 0.006) and those aged ≥55 years (28 of 115 [24%] vs 21 of 143 [15%], p = 0.049). The incidence of atrial septal aneurysm was similar in the 2 groups irrespective of patient age, as was the prevalence of complex atheromatous plaques. Multivariate analysis showed that PFO was independently associated with CS, irrespective of patient age (<55 years: odds ratio 2.4, 95% confidence interval 1.3 to 4.5, p = 0.01; ≥55 years: odds ratio 1.9, 95% confidence interval 1.1 to 3.5, p = 0.03). In conclusion, PFO was significantly associated with CS in younger (aged <55 years) and older (aged ≥55 years) patients. Atrial septal aneurysm and complex atheromas in the ascending aorta and aortic arch do not appear to be associated with CS.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>21889761</pmid><doi>10.1016/j.amjcard.2011.07.058</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Aorta, Thoracic Aortic Diseases - complications Aortic Diseases - diagnostic imaging Atherosclerosis Atherosclerosis (general aspects, experimental research) Atherosclerosis - complications Atherosclerosis - diagnostic imaging Biological and medical sciences Blood and lymphatic vessels Brain Ischemia - complications Brain Ischemia - diagnostic imaging Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular system Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava Echocardiography, Transesophageal Female Foramen Ovale, Patent - complications Foramen Ovale, Patent - diagnostic imaging Heart Humans Investigative techniques, diagnostic techniques (general aspects) Ischemia Male Medical sciences Neurology Retrospective Studies Risk factors Stroke Stroke - complications Stroke - diagnostic imaging Ultrasonic imaging Ultrasonic investigative techniques Vascular diseases and vascular malformations of the nervous system |
| title | Comparison of Frequencies of Patent Foramen Ovale and Thoracic Aortic Atherosclerosis in Patients With Cryptogenic Ischemic Stroke Undergoing Transesophageal Echocardiography |
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