知识与财富的链接
目的 观察经食管超声心动图(TEE)联合右心声学造影(ASCE)用于识别高危卵圆孔未闭(PFO)形态特征及评估PFO相关性卒中风险的可行性。方法 纳入212例经TEE联合ASCE确诊的PFO,以其中100例合并隐源性卒中(CS)者为CS组、112例未合并者为非CS组;对比2组PFO形态学特征,筛选CS相关因素。结果 CS组静息态及激发态下PFO左、右心房面开口内径均大于非CS组,主动脉根部内径大于非CS组,房间隔膨出瘤(ASA)、房间隔高活动度、下腔静脉(IVC)瓣或希阿里氏网、激发态下大量右向左分流(RLS)及卵圆瓣多出口发生率均高于非CS组(P均<0.05)。logistic回归分析显示,ASA、房间隔高活动度、大量RLS及卵圆瓣多出口均与CS独立相关(OR=0.211、0.384、0.999、0.199,P均<0.05)。结论 TEE联合ASCE可识别高危PFO解剖特征、评估PFO相关性卒中风险。
Objective To observe the feasibility of transesophageal echocardiography (TEE) combined with agitated saline contrast echocardiography (ASCE) for identifying morphological characteristics of high-risk patent foramen ovale (PFO) and evaluating the risk of PFO related stroke. Methods Totally 212 PFO patients diagnosed by TEE combined with ASCE were enrolled, including 100 cases with cryptogenic stroke (CS) (CS group) and 112 without CS (non-CS group). Anatomical morphological characteristics of PFO were comparatively analyzed between groups to screen the independent factors of CS. Results In CS group, the left and right atrial opening diameters of PFO were all larger than those in non-CS group in both resting-state and stimulated state. The aortic root diameter in CS group was larger than that in non-CS group, and the incidence of atrial septal aneurysm (ASA), high activity of the atrial septum, inferior vena cava valve or Chiari network, large amount of right-to-left-shunt (RLS) in stimulated state, and multiple outlets of the oval valve in CS group were all higher than those in non-CS group (all P＜0.05). Logistic regression analysis showed that ASA, high atrial septal activity, large amount of RLS and multiple oval valve outlets were all independent factors associated with CS (OR=0.211, 0.384, 0.999, 0.199, all P＜0.05). Conclusion TEE combined with ASCE could identify anatomical characteristics of high-risk PFO and assess the risk of PFO related stroke.
