Chambers John, Seed Paul T, Ridsdale Leone
King's College London, London, UK; Guy's ans St Thomas' Hospitals, London, UK.
Int J Cardiol. 2013 Oct 9;168(4):3949-53. doi: 10.1016/j.ijcard.2013.06.054. Epub 2013 Jul 23.
The relationship between migrainous aura and patent foramen ovale (PFO) remains uncertain
We performed 'bubble' contrast transthoracic echocardiography on 80 migraineurs with 4-15 headache days per calendar month, mean age 45 (75% female) with mean 9.4 headache days. A large PFO was defined by passage of an uncountable bolus of bubbles or complete opacification of the left-heart in ≤3 cycles, while a moderate PFO was defined by passage of ≥20 bubbles but not sufficient to form a bolus or opacify the whole of the left heart.
There was a moderate or large PFO in 28 (35%; 95% CI 24-46%). There were atrial septal aneurysms in 11 (15%) and the relationship with PFO was moderately strong (spearman rank correlation 0.493, CI 0.308 to 0.643; p < 0.0001). Seven (9%) had a valve abnormality and one had a closure device for an atrial septal defect. Aura were reported in 31 (39%) and in these the PFO was large in 9 (29%) compared with 8 (16%; p = 0.143) without aura. There was no relationship between the size of the PFO and the number of headache days (difference between no PFO and large PFO = -0.6 days; 95% CI -2.6 to +1.4; p-value for any difference between groups = 0.316).
The prevalence of moderate or large patent foramen ovale was 35% and was not associated with the presence of aura or the frequency of the headache.
偏头痛性先兆与卵圆孔未闭（PFO）之间的关系仍不明确。
我们对80名偏头痛患者进行了“气泡”对比经胸超声心动图检查，这些患者每月有4 - 15天头痛，平均年龄45岁（75%为女性），平均头痛天数为9.4天。大的PFO定义为在≤3个心动周期内有不可计数的气泡团通过或左心完全显影，而中度PFO定义为有≥20个气泡通过但不足以形成气泡团或使整个左心显影。
28例（35%；95%可信区间24 - 46%）存在中度或大的PFO。11例（15%）存在房间隔瘤，其与PFO的关系中等强度（斯皮尔曼等级相关系数0.493，可信区间0.308至0.643；p < 0.0001）。7例（9%）有瓣膜异常，1例有房间隔缺损封堵装置。31例（39%）报告有先兆，其中9例（29%）PFO大，无先兆的患者中有8例（16%）PFO大（p = 0.143）。PFO大小与头痛天数之间无相关性（无PFO与大PFO之间的差异=-0.6天；95%可信区间-2.6至+1.4；组间任何差异的p值=0.316）。
中度或大的卵圆孔未闭患病率为35%，与先兆的存在或头痛频率无关。
