Send to

Choose Destination
See comment in PubMed Commons below
Am J Cardiol. 2010 Jul 1;106(1):129-34. doi: 10.1016/j.amjcard.2010.02.025. Epub 2010 May 13.

Association between anatomic features of atrial septal abnormalities obtained by omni-plane transesophageal echocardiography and stroke recurrence in cryptogenic stroke patients with patent foramen ovale.

Author information

Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.


The association between the anatomic characteristics obtained by omni-plane transesophageal echocardiography (TEE) and stroke recurrence in patients with cryptogenic stroke and patent foramen ovale (PFO) remains unclear. In the present longitudinal follow-up study, we sought to investigate whether PFO findings assessed by TEE can predict stroke recurrence. Of the 1,014 consecutive patients with acute ischemic stroke referred for TEE, 184 (mean +/- SD age, 51 +/- 14 years) were classified as having cryptogenic stroke with PFO, and follow-up data were available for 181 patients. During follow-up (median 3.5 years), 14 patients (7.7%) experienced stroke recurrence. Multivariate analysis showed that atrial septal aneurysm or hypermobility of the atrial septum (hazard ratio 6.04, 95% confidence interval 1.84 to 19.86, p = 0.003) and PFO size (hazard ratio 3.00, 95% confidence interval 1.96 to 4.60, p <0.0001) were independent predictors of stroke recurrence. The optimal cutoff value of PFO to predict stroke recurrence within 3 years was 3.0 mm (95% confidence interval 2.1 to 3.7 mm, area under the curve 0.889, p <0.001) with a sensitivity and specificity of 90.0% and 79.4%, respectively. Using this cutoff, the 3-year stroke recurrence-free survival rates differed significantly (98.9 +/- 1.1% vs 71.5 +/- 16.2%, p <0.001). In conclusion, our data suggest that risk stratification might be possible using the findings from TEE. The prophylactic benefit of PFO closure from these findings needs additional investigation.

[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center