Sun Jing Ping, Meng Fanxia, Yang Xing Sheng, Lee Alex Pui-Wai, Chen Ming, Zhang Bo, Yu Cheuk-Man
Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
East Hospital, Tongji University, Shanghai, China.
Int J Cardiol. 2016 Jul 1;214:37-40. doi: 10.1016/j.ijcard.2016.03.119. Epub 2016 Mar 24.
It has been postulated that atrial septal pouch (ASP) may favor the stasis of blood and predispose to thromboembolic complications. We sought to evaluate the prevalence of ASP, and its association with ischemic stroke.
We retrospectively studied 500 patients, who underwent transesophageal echocardiography (TEE) due to clinical indications. Seventy two patients due to image quality, and 104 patients with atrial septal defect or PFO were excluded. The remaining 324 patients were included in the analysis. The depth of ASP was measured.
ASP was detected in 98 patients [left side ASP (LASP) in 58 (59.2%), and right side ASP (RASP) in 40 (40.8%) patients]. LASPs were significant deeper than RASPs (10.1±5.2 vs 4.4±1.4mm, p<0.0001). Patient characteristics were categorized by the presence or absence of LASP. The age (61±12 vs 61±12), gender and stroke risk factors were no significant difference between patients with or without LAPS. Ischemic stroke occurred in 21 patients without LASP, 10 patients with LASP. The presence of a LASP was found to be associated with an increased risk of ischemic stroke, in either univariable analysis (17.2 vs. 7.9%, p=0.03; OR=2.43, 95% CI=1.1-5.5, p=0.033) or after adjustment for other stroke risk factors using multiple logistic regression analysis (OR=2.45, 95% CI 1.1-5.8, p=0.036).
This study demonstrated evidence of association between LASP and ischemic stroke. Among 324 patients, the risk of ischemic stroke was twice more among patients with LASP than cases without LASP.
据推测，房间隔袋（ASP）可能有利于血液淤滞，并易引发血栓栓塞并发症。我们试图评估ASP的患病率及其与缺血性卒中的关联。
我们回顾性研究了500例因临床指征接受经食管超声心动图（TEE）检查的患者。72例因图像质量问题，104例患有房间隔缺损或卵圆孔未闭的患者被排除。其余324例患者纳入分析。测量ASP的深度。
98例患者检测到ASP [左侧ASP（LASP）58例（59.2%），右侧ASP（RASP）40例（40.8%）]。LASP明显比RASP深（10.1±5.2 vs 4.4±1.4mm，p<0.0001）。根据是否存在LASP对患者特征进行分类。有或无LASP的患者在年龄（61±12 vs 61±12）、性别和卒中危险因素方面无显著差异。21例无LASP的患者、10例有LASP的患者发生了缺血性卒中。发现存在LASP与缺血性卒中风险增加相关，在单变量分析中（17.2%对7.9%，p=0.03；OR=2.43，95%CI=1.1 - 5.5，p=0.033），或在使用多因素逻辑回归分析调整其他卒中危险因素后（OR=2.45，95%CI 1.1 - 5.8，p=0.036）。
本研究证明了LASP与缺血性卒中之间存在关联的证据。在324例患者中，有LASP的患者发生缺血性卒中的风险是无LASP患者的两倍。
