ATRIAL SEPTAL ANEURYSM AND PATENT FORAMEN OVALE AS RISK-FACTORS FOR CRYPTOGENIC STROKE IN PATIENTS LESS-THAN 55 YEARS OF AGE - A STUDY USING TRANSESOPHAGEAL ECHOCARDIOGRAPHY
ATRIAL SEPTAL ANEURYSM AND PATENT FORAMEN OVALE AS RISK-FACTORS FOR CRYPTOGENIC STROKE IN PATIENTS LESS-THAN 55 YEARS OF AGE - A STUDY USING TRANSESOPHAGEAL ECHOCARDIOGRAPHY
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DOI：
10.1161/01.str.24.12.1865
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发表时间：
1993-12-01
期刊：
影响因子：
8.3
通讯作者：
DERECONDO, J
中科院分区：
文献类型：
--
作者：
CABANES, L;MAS, JL;DERECONDO, J
背景和目的：房间隔动脉瘤和栓塞事件之间的联系已经被提出。房间隔动脉瘤已被证明与卵圆孔未闭有关，在一些报告中，与二尖瓣脱垂有关。后两种心脏疾病已被确定为缺血性卒中的潜在危险因素。本前瞻性研究的目的是评估房间隔动脉瘤作为中风的独立危险因素的作用，特别是对于隐源性stroke.Methods：我们研究了房间隔动脉瘤，卵圆孔未闭，二尖瓣脱垂的患病率在100例连续< 55岁的缺血性中风患者进行了广泛的病因调查。我们将这些结果与50例连续患者的对照组进行了比较。经食管超声心动图诊断房间隔瘤和卵圆孔未闭，二维经胸超声心动图诊断二尖瓣脱垂。（比值比，4.3; 95%置信区间，1.3至14.6; P=.01）和卵圆孔未闭（比值比，3.9; 95%可信区间，1.5 - 10; P= 0.003）而不是二尖瓣脱垂与隐源性卒中的诊断显著相关。同时患有房间隔动脉瘤和卵圆孔未闭的患者的中风几率是没有这两种心脏疾病的患者的中风几率的33.3倍（95%置信区间，4.1 - 270）。对于房间隔动脉瘤偏移> 10 mm的患者，卒中几率约为房间隔动脉瘤偏移10 mm患者卒中几率的8倍< 10 mm.Conclusions: This study shows that atrial septal aneurysm and patent foramen ovale are both significantly associated with cryptogenic stroke and that their association has a marked synergistic effect. Atrial septal aneurysms of >，卒中风险较高。
Background and Purpose: An association between atrial septal aneurysm and embolic events has been suggested. Atrial septal aneurysm has been shown to be associated with patent foramen ovale and, in some reports, with mitral valve prolapse. These two latter cardiac disorders have been identified as potential risk factors for ischemic stroke. The aim of this prospective study was to assess the role of atrial septal aneurysm as an independent risk factor for stroke, especially for cryptogenic stroke.Methods: We studied the prevalence of atrial septal aneurysm, patent foramen ovale, and mitral valve prolapse in 100 consecutive patients < 55 years of age with ischemic stroke who underwent extensive etiological investigations. We compared these results with those in a control group of 50 consecutive patients. The diagnosis of atrial septal aneurysm and patent foramen ovale relied on transesophageal echocardiography with a contrast study and that of mitral valve prolapse, on two-dimensional transthoracic echocardiography.Results: Stepwise logistic regression analysis showed that atrial septal aneurysm (odds ratio, 4.3; 95% confidence interval, 1.3 to 14.6; P=.01) and patent foramen ovale (odds ratio, 3.9; 95% confidence interval, 1.5 to 10; P=.003) but not mitral valve prolapse were significantly associated with the diagnosis of cryptogenic stroke. The stroke odds of a patient with both atrial septal aneurysm and patent foramen ovale were 33.3 times (95% confidence interval, 4.1 to 270) the stroke odds of a patient with neither of these cardiac disorders. For a patient with atrial septal aneurysm of > 10-mm excursion, the stroke odds were approximately 8 times the stroke odds of a patient with atrial septal aneurysm of < 10 mm.Conclusions: This study shows that atrial septal aneurysm and patent foramen ovale are both significantly associated with cryptogenic stroke and that their association has a marked synergistic effect. Atrial septal aneurysms of >10-mm excursion are associated with a higher risk of stroke.