Diagnosis of Patent Foramen Ovale: The Combination of Contrast Transcranial Doppler, Contrast Transthoracic Echocardiography, and Contrast Transesophageal Echocardiography
Objectives. To access the distinct values of contrast transcranial Doppler (cTCD), contrast transthoracic echocardiography (cTTE), and contrast transesophageal echocardiography (cTEE) in the diagnosis of right-to-left shunt (RLS) due to patent foramen ovale (PFO) and to define the most practical str...
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| description | Objectives. To access the distinct values of contrast transcranial Doppler (cTCD), contrast transthoracic echocardiography (cTTE), and contrast transesophageal echocardiography (cTEE) in the diagnosis of right-to-left shunt (RLS) due to patent foramen ovale (PFO) and to define the most practical strategy for the diagnosis of PFO. Methods. 102 patients with a high clinical suspicion for PFO had simultaneous cTCD, cTTE, and cTEE performed. The agitated saline mixed with blood was used to detect right-to-left shunt (RLS). Results. In all 102 patients, the shunt was detected at rest by cTCD in 60.78% of cases, by cTTE in 42.16%, and by cTEE in 47.06%. The positive results of all 3 techniques with Valsalva maneuver (VM) were significantly improved. cTCD showed higher pick-up rate than cTTE (98.04% vs. 89.22%; χ2=12.452, p |
| doi_str_mv | 10.1155/2020/8701759 |
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To access the distinct values of contrast transcranial Doppler (cTCD), contrast transthoracic echocardiography (cTTE), and contrast transesophageal echocardiography (cTEE) in the diagnosis of right-to-left shunt (RLS) due to patent foramen ovale (PFO) and to define the most practical strategy for the diagnosis of PFO. Methods. 102 patients with a high clinical suspicion for PFO had simultaneous cTCD, cTTE, and cTEE performed. The agitated saline mixed with blood was used to detect right-to-left shunt (RLS). Results. In all 102 patients, the shunt was detected at rest by cTCD in 60.78% of cases, by cTTE in 42.16%, and by cTEE in 47.06%. The positive results of all 3 techniques with Valsalva maneuver (VM) were significantly improved. cTCD showed higher pick-up rate than cTTE (98.04% vs. 89.22%; χ2=12.452, p<0.05) and the cTEE (98.04% vs. 96.08%; nonsignificant difference) in the diagnosis of PFO. Nevertheless, cTEE, compared with cTTE, underestimated shunting in 44% of patients. The diameter of both PFO entrance and exit was significantly greater in patients with a severe shunt compared with a mild shunt (2.8±1.0 mm vs. 2.0±0.7 mm, t=3.135, p<0.05; 2.2±0.7 mm vs. 1.6±0.4 mm, t=−2.582, p<0.05). There was a nonsignificant difference in tunnel length between patients with mild shunting and severe shunting(9.3±2.7 mm vs. 9.4±2.9 mm; t=1.358, p>0.05). Conclusions. The best method to diagnose PFO should be the combination of cTCD, cTTE, and cTEE. And cTCD should be applied as the first choice for screening RLS. Then, cTTE should be performed to quantify the severity of the shunt. Last but not least, cTEE should be performed to assess the morphologies of PFO when the closure is planned. The study provides for clinicians the most practical strategy for diagnosing PFO in the future. However, further trials with a large sample size are required to confirm this finding.</description><identifier>ISSN: 2314-6133</identifier><identifier>EISSN: 2314-6141</identifier><identifier>DOI: 10.1155/2020/8701759</identifier><identifier>PMID: 32185222</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Publishing Corporation</publisher><subject>Abdomen ; Adolescent ; Adult ; Aged ; Cardiovascular disease ; Clinical trials ; Contrast Media - administration & dosage ; Diagnosis ; Doppler effect ; Echocardiography ; Echocardiography - methods ; Echocardiography, Transesophageal - methods ; Entrances ; Female ; Flow velocity ; Foramen Ovale, Patent - diagnosis ; Humans ; Male ; Middle Aged ; Morphology ; Patients ; Standard deviation ; Stroke ; Studies ; Ultrasonic imaging ; Ultrasonography, Doppler, Transcranial - methods ; Ultrasound ; Valsalva Maneuver - physiology ; Young Adult</subject><ispartof>BioMed research international, 2020, Vol.2020 (2020), p.1-7</ispartof><rights>Copyright © 2020 Xiaoxue Yang et al.</rights><rights>COPYRIGHT 2020 John Wiley & Sons, Inc.</rights><rights>Copyright © 2020 Xiaoxue Yang et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. http://creativecommons.org/licenses/by/4.0</rights><rights>Copyright © 2020 Xiaoxue Yang et al. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c499t-fb8c58e2828b96d094e86bac45772ddca112ec143642aadcbda78515940bc6b3</citedby><cites>FETCH-LOGICAL-c499t-fb8c58e2828b96d094e86bac45772ddca112ec143642aadcbda78515940bc6b3</cites><orcidid>0000-0002-8943-8548 ; 0000-0002-3091-7085 ; 0000-0001-5009-439X ; 0000-0003-1562-859X ; 0000-0001-5278-5274 ; 0000-0002-8377-8322</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7060853/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7060853/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,4024,27923,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32185222$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Gaibazzi, Nicola</contributor><contributor>Nicola Gaibazzi</contributor><creatorcontrib>Liu, Baomin</creatorcontrib><creatorcontrib>Zhai, Nina</creatorcontrib><creatorcontrib>Wei, Yajuan</creatorcontrib><creatorcontrib>Wang, Hua</creatorcontrib><creatorcontrib>Yang, Xiaoxue</creatorcontrib><creatorcontrib>Li, Xiaopeng</creatorcontrib><title>Diagnosis of Patent Foramen Ovale: The Combination of Contrast Transcranial Doppler, Contrast Transthoracic Echocardiography, and Contrast Transesophageal Echocardiography</title><title>BioMed research international</title><addtitle>Biomed Res Int</addtitle><description>Objectives. To access the distinct values of contrast transcranial Doppler (cTCD), contrast transthoracic echocardiography (cTTE), and contrast transesophageal echocardiography (cTEE) in the diagnosis of right-to-left shunt (RLS) due to patent foramen ovale (PFO) and to define the most practical strategy for the diagnosis of PFO. Methods. 102 patients with a high clinical suspicion for PFO had simultaneous cTCD, cTTE, and cTEE performed. The agitated saline mixed with blood was used to detect right-to-left shunt (RLS). Results. In all 102 patients, the shunt was detected at rest by cTCD in 60.78% of cases, by cTTE in 42.16%, and by cTEE in 47.06%. The positive results of all 3 techniques with Valsalva maneuver (VM) were significantly improved. cTCD showed higher pick-up rate than cTTE (98.04% vs. 89.22%; χ2=12.452, p<0.05) and the cTEE (98.04% vs. 96.08%; nonsignificant difference) in the diagnosis of PFO. Nevertheless, cTEE, compared with cTTE, underestimated shunting in 44% of patients. The diameter of both PFO entrance and exit was significantly greater in patients with a severe shunt compared with a mild shunt (2.8±1.0 mm vs. 2.0±0.7 mm, t=3.135, p<0.05; 2.2±0.7 mm vs. 1.6±0.4 mm, t=−2.582, p<0.05). There was a nonsignificant difference in tunnel length between patients with mild shunting and severe shunting(9.3±2.7 mm vs. 9.4±2.9 mm; t=1.358, p>0.05). Conclusions. The best method to diagnose PFO should be the combination of cTCD, cTTE, and cTEE. And cTCD should be applied as the first choice for screening RLS. Then, cTTE should be performed to quantify the severity of the shunt. Last but not least, cTEE should be performed to assess the morphologies of PFO when the closure is planned. The study provides for clinicians the most practical strategy for diagnosing PFO in the future. However, further trials with a large sample size are required to confirm this finding.</description><subject>Abdomen</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Cardiovascular disease</subject><subject>Clinical trials</subject><subject>Contrast Media - administration & dosage</subject><subject>Diagnosis</subject><subject>Doppler effect</subject><subject>Echocardiography</subject><subject>Echocardiography - methods</subject><subject>Echocardiography, Transesophageal - methods</subject><subject>Entrances</subject><subject>Female</subject><subject>Flow velocity</subject><subject>Foramen Ovale, Patent - diagnosis</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Morphology</subject><subject>Patients</subject><subject>Standard deviation</subject><subject>Stroke</subject><subject>Studies</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography, Doppler, Transcranial - methods</subject><subject>Ultrasound</subject><subject>Valsalva Maneuver - 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administration & dosage</topic><topic>Diagnosis</topic><topic>Doppler effect</topic><topic>Echocardiography</topic><topic>Echocardiography - methods</topic><topic>Echocardiography, Transesophageal - methods</topic><topic>Entrances</topic><topic>Female</topic><topic>Flow velocity</topic><topic>Foramen Ovale, Patent - diagnosis</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Morphology</topic><topic>Patients</topic><topic>Standard deviation</topic><topic>Stroke</topic><topic>Studies</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography, Doppler, Transcranial - methods</topic><topic>Ultrasound</topic><topic>Valsalva Maneuver - physiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Baomin</creatorcontrib><creatorcontrib>Zhai, Nina</creatorcontrib><creatorcontrib>Wei, Yajuan</creatorcontrib><creatorcontrib>Wang, Hua</creatorcontrib><creatorcontrib>Yang, Xiaoxue</creatorcontrib><creatorcontrib>Li, Xiaopeng</creatorcontrib><collection>الدوريات العلمية والإحصائية - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BioMed research international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Baomin</au><au>Zhai, Nina</au><au>Wei, Yajuan</au><au>Wang, Hua</au><au>Yang, Xiaoxue</au><au>Li, Xiaopeng</au><au>Gaibazzi, Nicola</au><au>Nicola Gaibazzi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnosis of Patent Foramen Ovale: The Combination of Contrast Transcranial Doppler, Contrast Transthoracic Echocardiography, and Contrast Transesophageal Echocardiography</atitle><jtitle>BioMed research international</jtitle><addtitle>Biomed Res Int</addtitle><date>2020</date><risdate>2020</risdate><volume>2020</volume><issue>2020</issue><spage>1</spage><epage>7</epage><pages>1-7</pages><issn>2314-6133</issn><eissn>2314-6141</eissn><abstract>Objectives. To access the distinct values of contrast transcranial Doppler (cTCD), contrast transthoracic echocardiography (cTTE), and contrast transesophageal echocardiography (cTEE) in the diagnosis of right-to-left shunt (RLS) due to patent foramen ovale (PFO) and to define the most practical strategy for the diagnosis of PFO. Methods. 102 patients with a high clinical suspicion for PFO had simultaneous cTCD, cTTE, and cTEE performed. The agitated saline mixed with blood was used to detect right-to-left shunt (RLS). Results. In all 102 patients, the shunt was detected at rest by cTCD in 60.78% of cases, by cTTE in 42.16%, and by cTEE in 47.06%. The positive results of all 3 techniques with Valsalva maneuver (VM) were significantly improved. cTCD showed higher pick-up rate than cTTE (98.04% vs. 89.22%; χ2=12.452, p<0.05) and the cTEE (98.04% vs. 96.08%; nonsignificant difference) in the diagnosis of PFO. Nevertheless, cTEE, compared with cTTE, underestimated shunting in 44% of patients. The diameter of both PFO entrance and exit was significantly greater in patients with a severe shunt compared with a mild shunt (2.8±1.0 mm vs. 2.0±0.7 mm, t=3.135, p<0.05; 2.2±0.7 mm vs. 1.6±0.4 mm, t=−2.582, p<0.05). There was a nonsignificant difference in tunnel length between patients with mild shunting and severe shunting(9.3±2.7 mm vs. 9.4±2.9 mm; t=1.358, p>0.05). Conclusions. The best method to diagnose PFO should be the combination of cTCD, cTTE, and cTEE. And cTCD should be applied as the first choice for screening RLS. Then, cTTE should be performed to quantify the severity of the shunt. Last but not least, cTEE should be performed to assess the morphologies of PFO when the closure is planned. The study provides for clinicians the most practical strategy for diagnosing PFO in the future. However, further trials with a large sample size are required to confirm this finding.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Publishing Corporation</pub><pmid>32185222</pmid><doi>10.1155/2020/8701759</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-8943-8548</orcidid><orcidid>https://orcid.org/0000-0002-3091-7085</orcidid><orcidid>https://orcid.org/0000-0001-5009-439X</orcidid><orcidid>https://orcid.org/0000-0003-1562-859X</orcidid><orcidid>https://orcid.org/0000-0001-5278-5274</orcidid><orcidid>https://orcid.org/0000-0002-8377-8322</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Abdomen Adolescent Adult Aged Cardiovascular disease Clinical trials Contrast Media - administration & dosage Diagnosis Doppler effect Echocardiography Echocardiography - methods Echocardiography, Transesophageal - methods Entrances Female Flow velocity Foramen Ovale, Patent - diagnosis Humans Male Middle Aged Morphology Patients Standard deviation Stroke Studies Ultrasonic imaging Ultrasonography, Doppler, Transcranial - methods Ultrasound Valsalva Maneuver - physiology Young Adult |
| title | Diagnosis of Patent Foramen Ovale: The Combination of Contrast Transcranial Doppler, Contrast Transthoracic Echocardiography, and Contrast Transesophageal Echocardiography |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-20T07%3A05%3A05IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Diagnosis%20of%20Patent%20Foramen%20Ovale:%20The%20Combination%20of%20Contrast%20Transcranial%20Doppler,%20Contrast%20Transthoracic%20Echocardiography,%20and%20Contrast%20Transesophageal%20Echocardiography&rft.jtitle=BioMed%20research%20international&rft.au=Liu,%20Baomin&rft.date=2020&rft.volume=2020&rft.issue=2020&rft.spage=1&rft.epage=7&rft.pages=1-7&rft.issn=2314-6133&rft.eissn=2314-6141&rft_id=info:doi/10.1155/2020/8701759&rft_dat=%3Cgale_pubme%3EA624689407%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2374005611&rft_id=info:pmid/32185222&rft_galeid=A624689407&rfr_iscdi=true |