Patent foramen ovale and stroke: Difference between revisions
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==[[Patent foramen ovale]] and recurrent [[stroke]]== | ==[[Patent foramen ovale]] and recurrent [[stroke]]== | ||
There exists a discrepancy between | There exists a discrepancy between influence of [[patent foramen ovale]] ([[PFO]]) on recurrent [[stroke]] (after first episode of [[Paradoxical embolism|cryptogenic stroke]]). Several factors have been found associated with a [[patent foramen ovale]] ([[PFO]]) that might increase the incidence of recurrent [[strokes]] namely, [[atrial septal aneurysm]] <ref name="pmid11742048">{{cite journal| author=Mas JL, Arquizan C, Lamy C, Zuber M, Cabanes L, Derumeaux G et al.| title=Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both. | journal=N Engl J Med | year= 2001 | volume= 345 | issue= 24 | pages= 1740-6 | pmid=11742048 | doi=10.1056/NEJMoa011503 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11742048 }} </ref>, (ASA) in association with [[PFO]], bigger shunts, longer tunnels <ref name="pmid19101242">{{cite journal| author=Goel SS, Tuzcu EM, Shishehbor MH, de Oliveira EI, Borek PP, Krasuski RA et al.| title=Morphology of the patent foramen ovale in asymptomatic versus symptomatic (stroke or transient ischemic attack) patients. | journal=Am J Cardiol | year= 2009 | volume= 103 | issue= 1 | pages= 124-9 | pmid=19101242 | doi=10.1016/j.amjcard.2008.08.036 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19101242 }} </ref>. Nevertheless, some studies have found no association between [[PFO]] or abnormal septal morphology with recurrent [[strokes]] <ref name="pmid18818401">{{cite journal| author=Serena J, Marti-Fàbregas J, Santamarina E, Rodríguez JJ, Perez-Ayuso MJ, Masjuan J et al.| title=Recurrent stroke and massive right-to-left shunt: results from the prospective Spanish multicenter (CODICIA) study. | journal=Stroke | year= 2008 | volume= 39 | issue= 12 | pages= 3131-6 | pmid=18818401 | doi=10.1161/STROKEAHA.108.521427 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18818401 }} </ref>. | ||
==References== | ==References== | ||
Revision as of 15:07, 5 September 2011
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Patent Foramen Ovale Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [3]
Overview
Association of cryptogenic stroke/transient ischemic attacks with patent foramen ovale
- One in every four cases of ischemic stroke does not have an identifiable cause other than cryptogenic stroke which is a diagnosis of exclusion[1].
- Cryptogenic stroke occurs more commonly in younger patients.
- The association between the presence of a patent foramen ovale and cryptogenic stroke is controversial and inconsistent. While some studies have demonstrated an increased incidence of patent foramen ovale (PFO) in younger patients with cryptogenic stroke [2] others failed to show an association [3].
Patent foramen ovale and first stroke
Although, two prospective cohort studies namely, ‘ The Northern Manhattan Study’ (NOMAS) [4] and 'Stroke Prevention: Assessment of Risk in a Community' (SPARC) [5], found an increased incidence of first stroke in patients with patent foramen ovale, both these studies did not reach a statistical significance.
Patent foramen ovale and recurrent stroke
There exists a discrepancy between influence of patent foramen ovale (PFO) on recurrent stroke (after first episode of cryptogenic stroke). Several factors have been found associated with a patent foramen ovale (PFO) that might increase the incidence of recurrent strokes namely, atrial septal aneurysm [6], (ASA) in association with PFO, bigger shunts, longer tunnels [7]. Nevertheless, some studies have found no association between PFO or abnormal septal morphology with recurrent strokes [8].
References
- ↑ Sacco RL, Ellenberg JH, Mohr JP, Tatemichi TK, Hier DB, Price TR; et al. (1989). "Infarcts of undetermined cause: the NINCDS Stroke Data Bank". Ann Neurol. 25 (4): 382–90. doi:10.1002/ana.410250410. PMID 2712533.
- ↑ Overell JR, Bone I, Lees KR (2000). "Interatrial septal abnormalities and stroke: a meta-analysis of case-control studies". Neurology. 55 (8): 1172–9. PMID 11071496.
- ↑ Poppert H, Morschhaeuser M, Feurer R, Bockelbrink A, Schwarze J, Esposito L; et al. (2008). "Lack of association between right-to-left shunt and cerebral ischemia after adjustment for gender and age". J Negat Results Biomed. 7: 7. doi:10.1186/1477-5751-7-7. PMC 2577085. PMID 18851751.
- ↑ Di Tullio MR, Sacco RL, Sciacca RR, Jin Z, Homma S (2007). "Patent foramen ovale and the risk of ischemic stroke in a multiethnic population". J Am Coll Cardiol. 49 (7): 797–802. doi:10.1016/j.jacc.2006.08.063. PMID 17306710.
- ↑ Meissner I, Khandheria BK, Heit JA, Petty GW, Sheps SG, Schwartz GL; et al. (2006). "Patent foramen ovale: innocent or guilty? Evidence from a prospective population-based study". J Am Coll Cardiol. 47 (2): 440–5. doi:10.1016/j.jacc.2005.10.044. PMID 16412874.
- ↑ Mas JL, Arquizan C, Lamy C, Zuber M, Cabanes L, Derumeaux G; et al. (2001). "Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both". N Engl J Med. 345 (24): 1740–6. doi:10.1056/NEJMoa011503. PMID 11742048.
- ↑ Goel SS, Tuzcu EM, Shishehbor MH, de Oliveira EI, Borek PP, Krasuski RA; et al. (2009). "Morphology of the patent foramen ovale in asymptomatic versus symptomatic (stroke or transient ischemic attack) patients". Am J Cardiol. 103 (1): 124–9. doi:10.1016/j.amjcard.2008.08.036. PMID 19101242.
- ↑ Serena J, Marti-Fàbregas J, Santamarina E, Rodríguez JJ, Perez-Ayuso MJ, Masjuan J; et al. (2008). "Recurrent stroke and massive right-to-left shunt: results from the prospective Spanish multicenter (CODICIA) study". Stroke. 39 (12): 3131–6. doi:10.1161/STROKEAHA.108.521427. PMID 18818401.