Patent Foramen Ovale and the Risk of Cerebral Infarcts in Acute Pulmonary Embolism-A Prospective Observational Study
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, pozorovací studie
PubMed
29031497
DOI
10.1016/j.jstrokecerebrovasdis.2017.09.004
PII: S1052-3057(17)30475-5
Knihovny.cz E-zdroje
- Klíčová slova
- Pulmonary embolism, brain infarction, brain magnetic resonance imaging, echocardiography, patent foramen ovale,
- MeSH
- antikoagulancia aplikace a dávkování MeSH
- aplikace orální MeSH
- barevná dopplerovská echokardiografie MeSH
- časové faktory MeSH
- cerebrální infarkt diagnostické zobrazování etiologie MeSH
- CT angiografie MeSH
- difuzní magnetická rezonance MeSH
- echokardiografie transezofageální MeSH
- foramen ovale apertum komplikace diagnostické zobrazování MeSH
- lidé MeSH
- logistické modely MeSH
- magnetická rezonanční angiografie MeSH
- odds ratio MeSH
- paradoxní embolie diagnostické zobrazování etiologie MeSH
- plicní embolie komplikace diagnostické zobrazování farmakoterapie MeSH
- prospektivní studie MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- Názvy látek
- antikoagulancia MeSH
BACKGROUND: Pulmonary embolism (PE) is associated with a risk of consecutive paradoxical embolism with brain infarction through a patent foramen ovale (PFO). The aims of this study were to assess the rate of new ischemic brain lesions (IBLs) using magnetic resonance imaging (MRI) during a 12-month follow-up period with anticoagulation and to evaluate the potential relationship with the presence of PFO on transesophageal echocardiography (TEE). SUBJECTS AND METHODS: Seventy-eight patients with acute PE underwent baseline contrast TEE with brain MRI. After the 12-month follow-up, 58 underwent brain MRI. The rates of MRI documenting new IBLs were measured based on the presence of PFO. RESULTS: PFO was detected in 31 patients (39.7%). At baseline MRI, IBL was present in 39 of 78 patients (50%). The presence of IBL was not significantly higher in patients with PFO than in patients without PFO (20 [64.5% patients with PFO] versus 19 [40.4% without PFO] of 39 patients with baseline IBL, P = .063). At the follow-up MRI, in the group with new IBL (9 of 58 patients, 15.5%), the number of patients with PFO was significantly higher than that without PFO (7 [33.3%] versus 2 [5.4%], P = .008). PFO was identified as an independent predictor of new IBL (odds ratio 4.6 [1.6-47.4], P = .008). CONCLUSIONS: The presence of PFO was associated with new IBL in patients with PE. These patients are at a higher risk of ischemic stroke despite effective anticoagulation therapy.
Citace poskytuje Crossref.org
