Severance Hospital, Seoul, Republic of Korea.
Department of Neurology, Jeonbuk National University Medical School and Hospital, 20, Geonji-ro, Deokjin-gu, Jeollabuk-do, Jeonju, 54907, Republic of Korea.
Neurol Sci. 2021 Nov;42(11):4719-4721. doi: 10.1007/s10072-021-05394-w. Epub 2021 Jun 16.
The patent foramen ovale (PFO) is an atrial septal tunnel with a flap-like opening, causing a right-to-left shunt (RLS) between the atrial chambers. There are few studies on ischemic stroke characteristics based on PFO subtypes. In this study, we investigated whether there are differences in clinical characteristics, RLS amount, and the etiology of stroke defined by the Trial of ORG 10,172 in Acute Stroke Treatment (TOAST) classification between PFO subtypes.
We retrospectively analyzed consecutive ischemic stroke patients with PFO who were admitted to the Jeonbuk National University Hospital from November 2013 to February 2015, and performed a microbubble test to detect RLS. The patients were divided into two groups according to RLS characteristics: constant RLS group and provoked RLS group. We compared the clinical characteristics and degree of RLS between the PFO subtypes.
Out of 144 ischemic patients evaluated in this study, 83 (58%) were classified into the constant RLS group and 61 (42%) into the provoked RLS group. The proportion of microembolic signal (MES) grades 3 and 4 was significantly higher in the constant RLS group than in the provoked RLS group. There were no statistical differences in the distribution of TOAST classification between the two groups.
The constant RLS group showed a higher proportion of high-grade MES than the provoked RLS group.
卵圆孔未闭（PFO）是一种带有瓣状开口的房间隔隧道，导致左右心房之间出现右向左分流（RLS）。目前关于基于 PFO 亚型的缺血性脑卒中特征的研究较少。在本研究中，我们研究了 PFO 亚型之间在临床特征、RLS 量和经组织型纤溶酶原激活物溶栓治疗急性脑卒中试验（TOAST）分类定义的脑卒中病因方面是否存在差异。
我们回顾性分析了 2013 年 11 月至 2015 年 2 月期间因 PFO 入住全北国立大学医院的连续缺血性脑卒中患者，并进行了微泡试验以检测 RLS。根据 RLS 特征将患者分为两组：持续 RLS 组和诱发 RLS 组。我们比较了 PFO 亚型之间的临床特征和 RLS 程度。
在本研究中评估的 144 例缺血性患者中，83 例（58%）被归类为持续 RLS 组，61 例（42%）被归类为诱发 RLS 组。持续 RLS 组中微栓子信号（MES）等级 3 和 4 的比例明显高于诱发 RLS 组。两组之间的 TOAST 分类分布无统计学差异。
持续 RLS 组的高等级 MES 比例高于诱发 RLS 组。
