The comparative analysis of pathogenic mechanisms of ischemic stroke in patients with and without Patent Foramen Ovale (PFO) was performed. 101 patients with cryptogenic stroke and stroke of known etiology were examined. All patients underwent a diagnostic protocol including brain CT/MRI scan, haemostatic system testing, ECG, standard echocardiography, transthoracal echocardiography with bubble test and transcranial Doppler with bubble test; 51 patient underwent transesophageal echocardiography. PFO was found in half of the patients with ischemic stroke. However, the paradoxical cerebral embolism could not be considered as a main stroke risk factor in the studied cases: the mechanism of stroke in PFO was clarified with the same frequency, as in patients without PFO. So, in the presence of other competing risk factors of cerebral lesion, PFO does not play independent pathogenic role in the genesis of brain ischemia.
Pathogenic heterogenety of ischemic stroke and patent foramen ovale
- Authors: Suslina Z.A.1, Fonyakin A.V.2, Chechetkin A.O.2, Glebov M.V.3, Geraskina L.A.2, Nikitin Y.M.4, Kravchenko M.A.2
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Affiliations:
- Research Centre of Neurology
- Research Center of Neurology
- Research Center of Neurology, Russian Academy of Medical Sciences
- Research center of Neurology
- Issue: Vol 2, No 3 (2008)
- Pages: 4-8
- Section: Original articles
- Submitted: 07.02.2017
- Published: 14.02.2017
- URL: https://www.annaly-nevrologii.com/journal/pathID/article/view/402
- DOI: https://doi.org/10.17816/psaic402
- ID: 402
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About the authors
Z. A. Suslina
Research Centre of Neurology
Email: andreychechetkin@gmail.com
Russian Federation, Moscow
Andrey V. Fonyakin
Research Center of Neurology
Email: andreychechetkin@gmail.com
ORCID iD: 0000-0001-5452-2152
D. Sci. (Med.), Prof., leading researcher, Head, Laboratory of cardioneurology, 2nd Neurological department, Institute of Clinical and Preventive Neurology
Russian Federation, MoscowAndrey O. Chechetkin
Research Center of Neurology
Author for correspondence.
Email: andreychechetkin@gmail.com
ORCID iD: 0000-0002-8726-8928
D. Sci. (Med.), Head, Ultrasound diagnostic laboratory
Russian Federation, MoscowM. V. Glebov
Research Center of Neurology, Russian Academy of Medical Sciences
Email: andreychechetkin@gmail.com
Russian Federation, Moscow
Lyudmila A. Geraskina
Research Center of Neurology
Email: andreychechetkin@gmail.com
ORCID iD: 0000-0002-1253-1082
Russian Federation, Moscow, Volokolamskoe shosse,80
Yu. M. Nikitin
Research center of Neurology
Email: andreychechetkin@gmail.com
Russian Federation, Moscow
Mikhail A. Kravchenko
Research Center of Neurology
Email: andreychechetkin@gmail.com
Russian Federation, Moscow
References
- Белоконь Н.А., Подзолков В.П. Врожденные пороки сердца. М.: Медицина, 1990.
- Иваницкий А.В., Голухова Е.З., Косенко А.И. Открытое овальное окно: роль в патогенезе ряда неврологических заболеваний и методы их лечения. Журн. неврол. и психиатрии им. С.С. Корсакова 2004; 5: 65–68.
- Онищенко Е.Ф. Открытое овальное окно и инсульт в клинической практике. Спб.: ЭЛБИИСпб., 2006.
- Фонякин А.В., Суслина З.А., Гераскина Л.А. Кардиологическая диагностика при ишемическом инсульте. Спб.: Инкарт, 2005.
- Функциональная диагностика в кардиологии. В 22х т. Бокерия Л.А., Голухова Е.З., Иваницкий А.В. (ред.) М.: НЦССХ им. А.Н. Бакулева, 2005.
- Basic identification criteria of Doppler microembolic signals. Consensus Committee of the Ninth International Cerebral Hemodynamic Symposium. Stroke 1995; 26: 1123.
- Cohnheim J. Thrombose und Embolie: Vorlesung ueber allgemeine Pathologie. Berlin: Hirschwald, 1877: 175–177.
- Di Tullio M., Sacco R.L., Venketasubramanian N. et al. Comparison of diagnostic techniques for the detection of a patent foramen ovale in stroke patients. Stroke 1993; 24: 1020–1024.
- Eggebrecht H., Naber C.K., Plato C. et al. Analysis of fossa ovalis membrane velocities by transesophageal Doppler tissue echocardiography: a novel approach to functional assessment of patent foramen ovale. J. Am. Soc. Echocardiogr. 2004; 17: 1161–1166.
- Feigenbaum H., Armstrong W.E., Ryan T. Feigenbaum`s echocardiography, 6th ed. Philadelphia: Lippincott Williams & Wilkins, 2005.
- Jauss M., Zanette E. Detection of rightttooleft shunt with ultrasound contrast agent and transcranial Doppler sonography. Cerebrovasc. Dis. 2000; 10: 490–496.
- Kizer J.R., Richard B., Devereux M.D. et al. Patent foramen ovale in young adults with unexplained stroke. N. Engl. J. Med. 2005; 353: 2361–2372.
- Lamy C., Giannesini C., Zuber M. et al. Clinical and imaging findings in cryptogenic stroke patients with and without patent foramen ovale. The PFOOASA study. Stroke 2002; 33: 706–711.
- Lechat P., Mas J.L., Lascault G. et al. Prevalence of patent foramenovale in patients with stroke. New Eng. J. Med. 1988; 318: 1148–1152.
- Overell J.R., Bone I., Lees K.R. Interatrial septal abnormalities and stroke: a metaaanalysis of caseecontrol studies. Neurology 2000; 55: 1172–1179.
- Patten B.M., Taggart W.B. An unusual type of atrial heart. Arch. Pathol. 1929; 8: 894.
- Petty G.W., Khandheria B.K., Meissner I. et al. Populationnbased study of the relationship between patent foramen ovale and cerebrovascular ischemic events. Mayo Clin. Proc. 2006; 81: 597–601.
- Ranoux D., Cohen A., Cabanes L. et al. Patent Foramen Ovale: Is stroke due to paradoxical embolism? Stroke 1993; 24: 31–34.
- Sievert H., Taaffe M. Patent foramen ovale: the jury is still out. Eur. Heart J. 2004; 25: 361–362.