Kanda N, Yasaka M, Otsubo R, Nagatsuka K, Minematsu K, Yamaguchi T
Department of Medicine, National Cardiovascular Center, Osaka, Japan.
Rinsho Shinkeigaku. 1998 Mar;38(3):213-8.
Transesophageal echocardiography (TEE) has been used to detect cardiac abnormalities including right-to-left shunt (RLS) and atrial septal aneurysm (ASA). The aim of this study was to elucidate frequency of RLS and ASA detected by contrast-TEE, and to evaluate the role of these abnormalities in stroke patients.
We investigated prevalence of RLS and ASA in 504 patients suspected of stroke by using TEE. (mean age 62 +/- 12 y.o., stroke 491, non-stroke 13). The RLS was detected in 64 patients (12.7%), in whom 49 patients (9.7%) had the patent foramen ovale (PFO). The ASA was demonstrated in 10 patients (2.0%), and accompanied well with the RLS (six of the 10, 60%). The prevalent ratios of the RLS (33.8%), the PFO (26.8%), and the ASA (11.3%) in 71 patients with embolic stroke (brain embolism or TIA) of unknown cause were significantly higher than those in the other 433 patients (9.2%, 6.9%, 0.5%, respectively, p < 0.0001). Multiple logistic regression analysis showed that both the PFO and the ASA were independent risk factors (odds ratio: 3.8: p = 0.0002 and 16.6: p = 0.0008, respectively) for embolic stroke of unknown cause.
It seems that the RLS, PFO and the ASA play a roll in developing embolic stroke of unknown cause.
经食管超声心动图（TEE）已被用于检测包括右向左分流（RLS）和房间隔瘤（ASA）在内的心脏异常。本研究的目的是阐明经对比剂增强TEE检测到的RLS和ASA的发生率，并评估这些异常在中风患者中的作用。
我们使用TEE调查了504例疑似中风患者中RLS和ASA的患病率。（平均年龄62±12岁，中风患者491例，非中风患者13例）。64例患者（12.7%）检测到RLS，其中49例患者（9.7%）存在卵圆孔未闭（PFO）。10例患者（2.0%）显示有ASA，且与RLS密切相关（10例中有6例，60%）。71例病因不明的栓塞性中风（脑栓塞或短暂性脑缺血发作）患者中RLS（33.8%）、PFO（26.8%）和ASA（11.3%）的患病率显著高于其他433例患者（分别为9.2%、6.9%、0.5%，p<0.0001）。多因素logistic回归分析显示，PFO和ASA都是病因不明的栓塞性中风的独立危险因素（优势比分别为：3.8，p = 0.0002；16.6，p = 0.0008）。
RLS、PFO和ASA似乎在病因不明的栓塞性中风的发生中起作用。
