A comparison of contrast transthoracic echocardiography and contrast transcranial Doppler in cryptogenic stroke patients with patent foramen ovale. Issue 5 (2nd April 2019)

• Record Type: Journal Article
• Authors: Chen, Jie; Chen, Luyun; Hu, Wangwang; Ni, Xianda; Zhang, Zengrui; Feng, Xiaowen; Fan, Zijian; Chen, Cuiping; Qiu, Fengzhen; Shao, Bei
• Is Part Of: Brain and behavior. Volume 9:Issue 5(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-04-02
• Subjects: contrast transcranial Doppler -- contrast transthoracic echocardiography -- cryptogenic stroke -- patent foramen ovale -- transesophageal echocardiography; Neurology -- Periodicals; Neurosciences -- Periodicals; Psychology -- Periodicals; Psychiatry -- Periodicals; 616.8005
• DOI: 10.1002/brb3.1283
• Languages: English
• ISSNs: 2162-3279

Abstract

Abstract: Objective: In recent years, increasing attention has been paid to cryptogenic stroke (CS) caused by the patent foramen ovale (PFO). This study aims to compare contrast transthoracic echocardiography (cTTE) and contrast transcranial Doppler (cTCD) to determine whether cTTE is more suitable and reliable than cTCD for clinical use. Methods: From March 2017 to May 2018, patients who suffered from migraines, stroke, hypomnesis, or asymptomatic stroke found casually were included in our study. Patients with CS were semirandomly divided into two groups (cTTE and cTCD) according to the date of the outpatient visit. Patients with either of the examination above found positive were selected to finish transesophageal echocardiography (TEE). Results: In our study, the sensitivities of group cTTE positive (group cTTE+) and group cTCD positive (group cTCD+) did not have any statistical difference (89% vs. 80%, p = 0.236). Focusing on group cTCD+, we discovered that the semiquantitative shunt grading was not correlated with whether a PFO was present or not ( p = 0.194). However, once the PFO has been diagnosed, the shunt grading was shown to be related to the width of the gaps ( p = 0.032, p deviation = 0.03). Conclusion: Both cTTE and the cTCD can be used for preliminary PFO findings. The semiquantitative shunt grading of cTCD and cTTE can suggest the size of the PFO and the next course of treatment. The cTTE may be more significant to a safe PFO (a PFO does not have right‐to‐left shunts, RLSs). Combining cTTE and TEE could help diagnose PFO and assess CS risk. Abstract : The semiquantitative shunt grading of the contrast transcranial Doppler (cTCD) and contrast transthoracic echocardiography (cTTE) could suggest the size of patent foramen ovale (PFO), and makes sense for the next treatment. The cTTE may be more significant to a safe PFO (a PFO do not have right‐to‐left shunts, RLSs). Combining cTTE and transesophageal echocardiography could make up for each other to diagnose PFO and assess CS risk.