Abe Kaito, Hasegawa Fumiya, Nakajima Ryota, Fukui Hidetoshi, Shimada Moto, Miyazaki Takahiro, Doi Hiroshi, Endo Goro, Kanbara Kaori, Mochida Yasuyuki, Okuda Jun, Maeda Nobuya, Isoshima Akira, Tamura Koichi, Ishigami Tomoaki
Department of Cardiology, Omori Red Cross Hospital, 4-30-1 Chuo, Ota-Ward, Tokyo 143-8527, Japan.
Department of Medical Science and Cardiorenal Medicine, Yokohama City University, 3-9 Fukuura Kanazawa-Ward, Yokohama City 236-0004, Japan.
J Clin Med. 2021 Jan 18;10(2):332. doi: 10.3390/jcm10020332.
The comparative severity of patent foramen ovale (PFO)-related stroke in patients without atrial fibrillation (AF) and AF-related stroke in patients without PFO is unknown. Therefore, we compared the severity of PFO-related stroke and AF-related stroke. Twenty-six patients who underwent transesophageal echocardiography (TEE) were diagnosed with cardioembolic stroke from July 2018 to March 2020. Cases with AF detected by electrocardiograms or thrombus in the left atrium or left atrial appendage on TEE were included in the AF-related stroke group. Cases with a positive microbubble test on the Valsalva maneuver during TEE, and with no other factors that could cause stroke, were included in the PFO-related stroke group. This study was designed as a single-center, small population pilot study. The stroke severity of the two groups by the National Institute of Health Stroke Scale (NIHSS) score was compared by statistical analysis. Of the 26 cases, five PFO-related stroke patients and 21 AF-related stroke patients were analyzed. The NIHSS score was 2.2 ± 2.8 and 11.5 ± 9.2 (-value < 0.01), the rate of hypertension was 20.0% and 85.7% (-value = 0.01), and the HbA1c value was 5.5 ± 0.2% and 6.3 ± 1.3% (-value = 0.02) in the PFO-related and AF-related stroke groups, respectively. Compared with AF-related stroke patients, stroke severity was low in PFO-related stroke patients.
在没有心房颤动（AF）的患者中，卵圆孔未闭（PFO）相关卒中与在没有PFO的患者中AF相关卒中的相对严重程度尚不清楚。因此，我们比较了PFO相关卒中和AF相关卒中的严重程度。2018年7月至2020年3月期间，26例接受经食管超声心动图（TEE）检查的患者被诊断为心源性卒中。通过心电图检测到AF或TEE显示左心房或左心耳有血栓的病例被纳入AF相关卒中组。TEE期间Valsalva动作微泡试验呈阳性且无其他可能导致卒中因素的病例被纳入PFO相关卒中组。本研究设计为单中心、小样本试点研究。通过统计分析比较两组按美国国立卫生研究院卒中量表（NIHSS）评分的卒中严重程度。在这26例病例中，分析了5例PFO相关卒中患者和21例AF相关卒中患者。PFO相关卒中组和AF相关卒中组的NIHSS评分分别为2.2±2.8和11.5±9.2（P值<0.01），高血压发生率分别为20.0%和85.7%（P值=0.01），糖化血红蛋白（HbA1c）值分别为5.5±0.2%和6.3±1.3%（P值=0.02）。与AF相关卒中患者相比，PFO相关卒中患者的卒中严重程度较低。
