Research on the relationship between recurrence of cryptogenic ischemic cerebrovascular disease and patent foramen ovale

Abstract

Objective To evaluate the relationship between recurrence of cryptogenic ischemic cerebrovascular disease (CICVD) and patent foramen ovale (PFO)，as well as to access the clinical significance of PFO in ischemic cerebrovascular disease. Methods Consecutive patients with CICVD aged 15 to 70 years who were hospitalized in Department of Neurology，Xuanwu Hospital Capital Medical University from January 2008 to March 2011 were prospectively investigated.Identified by transesophageal echocardiography，patients were divided into two groups with respect to outcome: PFO group and non-PFO group.The recurrence of cerebral ischemic events was compared between the two groups after neurological follow-up. Results A total of 91 patients were recruited，including 57 patients with PFO and 34 patients without PFO.The follow-up period of two groups was 695 (506，1142) d.The recurrence rate at 15 months in patients with PFO (24.5% (12/49)) was higher than those without PFO (6.9% (2/29)，χ2=4.391，P=0.036).Cum hazard curve indicated that recurrence risk of cerebral ischemic events in patients with CICVD in PFO group was higher than that of patients in non-PFO group during the follow-up period (P=0.044).Cox model used for multivariate survival analysis indicated that PFO was a risk factor for cerebral ischemic event recurrence among patients with CICVD (OR=4.159，95% CI 1.178-14.689，P=0.027). Conclusions PFO is associated with increased recurrence risk of cerebral ischemia in CICVD patients.In addition，PFO may be a significant factor for ischemic cerebrovascular disease. Key words: Brain ischemia; Cerebrovascular disorders; Recurrence; Foramen ovale，patent