Truong Tam, Slavin Leo, Kashani Ramin, Higgins James, Puri Aarti, Chowdhry Malika, Cheung Philip, Tanious Adam, Child John S, Perloff Joseph K, Tobis Jonathan M
Department of Medicine, Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Am J Cardiol. 2008 Feb 1;101(3):396-400. doi: 10.1016/j.amjcard.2007.08.047.
The prevalence of migraine headaches (MH) is 12% in the general population and increases to 40% in patients with patent foramen ovale. This study evaluated the prevalence of MH in patients with congenital heart disease (CHD). Of 466 patients contacted from the UCLA Adult Congenital Heart Disease Center, 395 (85%) completed a questionnaire to determine the prevalence of MH. Patients were stratified by diagnosis of right-to-left, left-to-right, or no shunt. A group of 252 sex-matched patients with acquired cardiovascular disease served as controls. The prevalence of MH was 45% in adults with CHD compared to 11% in the controls (p<0.001). Of the 179 patients with MH, 143 (80%) had migraines with aura and 36 (20%) had migraines without aura versus 36% and 64% observed in the controls (p<0.001). The frequency of MH was 52% in the right-to-left shunt group, 44% in the left-to-right, and 38% in the no shunt group (p=NS). In patients with a right-to-left shunt who underwent surgical repair, 47% had complete resolution of MH, whereas 76% experienced >50% reduction in headache days per month. In conclusion, the prevalence of MH in all groups of adults with CHD is 3 to 4 times more than a sex-matched control population, with increasing prevalence of MH in patients with no shunt, left-to-right, and right-to-left shunt. The higher than expected frequency of MH in patients with CHD without an intracardiac shunt, suggests additional mechanisms to explain the significant association with MH.
偏头痛（MH）在普通人群中的患病率为12%，在卵圆孔未闭患者中增至40%。本研究评估了先天性心脏病（CHD）患者中MH的患病率。从加州大学洛杉矶分校成人先天性心脏病中心联系的466例患者中，395例（85%）完成了一份问卷以确定MH的患病率。患者按右向左、左向右或无分流诊断进行分层。一组252例性别匹配的获得性心血管疾病患者作为对照。CHD成人中MH的患病率为45%，而对照组为11%（p<0.001）。在179例MH患者中，143例（80%）有先兆偏头痛，36例（20%）无先兆偏头痛，而对照组分别为36%和64%（p<0.001）。右向左分流组MH的发生率为52%，左向右分流组为44%，无分流组为38%（p=无显著性差异）。在接受手术修复的右向左分流患者中，47%的患者MH完全缓解，而76%的患者每月头痛天数减少>50%。总之，所有CHD成人群体中MH的患病率是性别匹配对照组的3至4倍，无分流、左向右和右向左分流患者中MH的患病率均增加。CHD无心内分流患者中MH的发生率高于预期，提示有其他机制可解释与MH的显著关联。
