Shehata Ahmed, Nasser Abdulaziz, Mohsen Ahmed, Anwar Samaan Amir, Mostafa Amir, Hassan Mohamed
Cardiology Department, Cairo University, Giza, Egypt.
Cardiology Department, AlNas Hospital, Qalyubia, Egypt.
Egypt Heart J. 2024 Jun 10;76(1):73. doi: 10.1186/s43044-024-00504-3.
The reported prevalence of patent foramen ovale (PFO) in the general population is variable. It ranges between 8.6 and 42% according to the population studied and the imaging technique used. We aim to prospectively assess the prevalence and characteristics of PFO and interatrial septum (IAS) abnormalities as well as the related clinical manifestations in a sample of Egyptian population.
This study comprised 1000 patients who were referred for CT coronary angiography (CTCA). Mean age was 52.5 ± 10.9 years. The prevalence of PFO among the studied population was 16.3%; closed PFO (grade I) 44.2%, open PFO (grade II) 50.9%, and open PFO with jet (grade III) 4.9%. Anatomical high-risk PFO features-defined as the presence of at least 2 or more of the following (diameter ≥ 2 mm, length ≥ 10 mm, septal aneurysm "ASA", or redundant septum)-were found in 51.5% of PFOs' population. Other IAS abnormalities as redundant septum (8.6%), ASA (5.3%), Bachmann's bundle (4.5%), microaneurysm (2.6%), and atrial septal defect (ASD) (0.4%) were detected. There was a lower rate of coexistence of ASA with PFO (p = 0.031). Syncope was significantly higher in patients with PFO compared to those without PFO (6.7% vs. 1.6%, p = 0.001). Stroke, transient ischaemic attacks (TIA), and dizziness were similar in both groups. TIA, dizziness, and syncope were significantly higher in patients with IAS abnormalities including PFO compared to those without IAS abnormalities. Syncope was also significantly higher in PFO with high-risk anatomical features compared to those with non-high-risk PFO population (p = 0.02).
The prevalence of PFO in our study was approximately 16.3%, almost half of them showed anatomical high-risk features for stroke. Dizziness, syncope and TIA were significantly higher in patients with IAS abnormalities including PFO.
据报道，普通人群中卵圆孔未闭（PFO）的患病率存在差异。根据所研究的人群和使用的成像技术，其范围在8.6%至42%之间。我们旨在前瞻性评估埃及人群样本中PFO和房间隔（IAS）异常的患病率、特征以及相关临床表现。
本研究纳入了1000例因CT冠状动脉造影（CTCA）而就诊的患者。平均年龄为52.5±10.9岁。研究人群中PFO的患病率为16.3%；闭合性PFO（I级）占44.2%，开放性PFO（II级）占50.9%，伴有分流的开放性PFO（III级）占4.9%。在51.5%的PFO人群中发现了解剖学高危PFO特征，定义为存在以下至少2项或更多项（直径≥2mm、长度≥10mm、房间隔瘤“ASA”或冗余隔）。还检测到其他IAS异常，如冗余隔（8.6%）、ASA（5.3%）、巴赫曼束（4.5%）、微动脉瘤（2.6%）和房间隔缺损（ASD）（0.4%）。ASA与PFO共存的发生率较低（p = 0.031）。与无PFO的患者相比，有PFO的患者晕厥发生率显著更高（6.7%对1.6%，p = 0.001）。两组的中风、短暂性脑缺血发作（TIA）和头晕发生率相似。与无IAS异常的患者相比，包括PFO在内的IAS异常患者的TIA、头晕和晕厥发生率显著更高。与非高危PFO人群相比，具有高危解剖特征的PFO患者的晕厥发生率也显著更高（p = 0.02）。
我们研究中PFO的患病率约为16.3%，其中近一半表现出中风的解剖学高危特征。包括PFO在内的IAS异常患者的头晕、晕厥和TIA发生率显著更高。
