Prevalence of patent foramen ovale determined by transesophageal echocardiography in patients with cryptogenic stroke aged 55 years or older. Same as younger patients?

Rev Esp Cardiol. 2010 Mar;63(3):315-22. doi: 10.1016/s1885-5857(10)70064-5.
[Article in English, Spanish]

Abstract

Introduction and objectives: To investigate the relationship between patent foramen ovale and cryptogenic stroke in patients aged > or =55 years.

Methods: This prospective study determined the presence of patent foramen ovale and atrial septal aneurysm using transesophageal echocardiography in 262 consecutive patients with a diagnosis of probable cryptogenic stroke. Data from 44 patients aged > or =55 years with cryptogenic stroke (Group A) were compared with those from two other groups: 194 patients aged <55 years with cryptogenic stroke (Group B) and 24 control patients aged > or =55 years with stroke of known origin, namely grade III-V aortic atheromatosis (Group C).

Results: The frequency of patent foramen ovale in Group A was similar to that in Group B (38% vs. 36%; P=.85) but significantly higher than that in Group C (38% vs. 8%; P=.029). The frequency of patent foramen ovale with concomitant atrial septal aneurysm was significantly higher in the study group (Group A) than in the control Group C (18% vs. 0; P=.039) and non-significantly higher than in Group B (18% vs. 11%; P=.11).

Conclusions: The frequency of patent foramen ovale alone or in association with atrial septal aneurysm in patients with cryptogenic stroke aged > or =55 years was similar to that in those aged <55 years, but higher than that in patients aged > or =55 years with stroke of atherosclerotic origin. These data suggest that paradoxical embolism could be a cause of stroke in both age groups.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Echocardiography, Transesophageal*
  • Female
  • Foramen Ovale, Patent / complications*
  • Foramen Ovale, Patent / diagnostic imaging
  • Foramen Ovale, Patent / epidemiology*
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Stroke / complications*