The Study on the Relationship between Daily Activity and Patent Foramen Ovale_West China Medical Journal

Authors：

 LiuHaohao , MaWenjie ,  LiuYonghong , WuJianjun , ShaoLin , LaiHaiou , YinChenglong , QiZhanning , XiaHui , JiLi

Department of Neurology, Xianyang Hospital of Yan'an University, Xianyang, Shaanxi 712000, P. R. China;

Corresponding author：

LiuYonghong, Email: lyhb756@163.com

Keywords：

Patent foramen ovale; Right to left shunting; Transcranial Doppler foaming test; Right atrial pressure rise

DOI：

10.7507/1002-0179.20160059

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To study the relation between daily activity that can make right atrium pressure rise (such as abdominal belt, sighs, weight lifting) and patent foramen ovale (PFO). Methods A total of 122 cases of positive patients by the routine transcranial Doppler (TCD) foaming test between 2014 and 2015 were collected. Forty-one patients underwent TCD foaming test in the case of abdominal belt, 41 in the case of sighs, and 40 in the case of weight lifting. We recorded the right to left shunting of the above three cases, and compared them with the normal TCD foam test. Results There was a significant difference in the positive rate between the sigh group and abdominal belt group, and between the sigh group and weight lifting group (χ²=10.5, 7.40; P<0.01). The positive rate in the abdominal belt group was not significantly different from that of the weight lifting group (χ²=0.314, P>0.05). In the sigh group, the sigh shunting volume was significantly higher than that when the patients were at rest. The shunting volume was the biggest when the patients had Valsalva movement, followed by sighing and resting. Conclusion The daily activity that can make right atrium pressure rise (such as abdominal belt, sighs, weight lifting) can increase the shunting flow from the right to the left. The highest positive rate occurs when patients sigh. This study can provide a certain theoretical basis for the pathogenesis of patent foramen ovale and cryptogenic stroke.

Citation： LiuHaohao, MaWenjie, LiuYonghong, WuJianjun, ShaoLin, LaiHaiou, YinChenglong, QiZhanning, XiaHui, JiLi. The Study on the Relationship between Daily Activity and Patent Foramen Ovale. West China Medical Journal, 2016, 31(2): 212-215. doi: 10.7507/1002-0179.20160059 Copy

1.	Mesa D, Ruiz M, Delgado M, et al. Preva lence of patent foramen ovale determined by transesophageal echocardiography in patients with cryptogenic stroke aged 55 years or older. Same as younger patients[J]. Rev Esp Cardiol, 2010, 63(3):315-322.
2.	González-Alujas T, Evangelista A, Santamarina E, et al. Diagnosis and quantification of patent foramen ovale. Which is the reference technique? Simultaneous study with transcranial Doppler, transthoracic and transesophageal echocardiography[J]. Rev Esp Cardiol, 2011, 64(2):133-139.
3.	Komar M, Olszowska M, Przewłocki T, et al. Transcranial doppler ultrasonography should it be the first choice for persistent foramen ovale screening?[J]. Cardiovasc Ultrasound, 2014, 12:16.
4.	Zito C, Dattilo G, Oreto G, et al. Patent foramen ovale:comparison among diagnostic strategies in cryptogenic stroke and migraine[J]. Echocardiography, 2009, 26(5):495-503.
5.	Agustin SJ, Yumul MP, Kalaw AJ, et al. Effects of posture on right-to-left shunt detection by contrast transcranial doppler[J]. Stroke, 2011, 42(8):2201-2205.
6.	Shariat A, Yaghoubi E, Nemati R, et al. Comparison of agitated saline mixed with blood to agitated saline alone in detecting right-to-left shunt during contrast-transcranial Doppler sonography examination[J]. Acta Neurol Taiwan, 2011, 20(3):182-187.
7.	Droste DW, Jekentaite R, Stypmann J, et al. Contrast transcranial Doppler ultrasound in the detection of right-to-left shunts:comparison of Echovist-200 and Echovist-300, timing of the Valsalva maneuver, and general recommendations for the performance of the test[J]. Cerebrovasc Dis, 2002, 13(4):235-241.
8.	Basic identification criteria of Doppler microembolic signals. Consensus Committee of the Ninth International Cerebral Hemodynamic Symposium[J]. Stroke, 1995, 26(6):1123.
9.	Jauss M, Zanette E. Detection of right-to-left shunt with ultrasound contrast agent and transcranial Doppler sonography[J]. Cerebrovasc Dis, 2000, 10(6):490-496.
10.	TelmanG, Yalonetsky S, Kouperberg E, et al. Size of pfo and amount of microembolic signals in patients with ischaemic stroke or TIA[J]. Eur J Neurol, 2008, 15(9):969-972.
11.	杜微, 宋晓南, 杨戈, 等. 先天性卵圆孔未闭与缺血性卒中的最新研究进展[J]. 中风与神经疾病杂志, 2012, 29(7):669-672.
12.	Calvet D, Mas JL. Closure of patent foramen ovale in cryptogenic stroke:a never ending story[J]. Cerr Opin Neurol, 2014, 27(1):13-19.
13.	Overell JR, Bone I, Lees KR. Interatrial septal abnormalities and stroke:a meta-analysis of case-control studies[J]. Neurology, 2000, 55(8):1172-1179.
14.	杨方, 韩军良. 卵圆孔未闭所致脑栓塞1例报告[J]. 中国卒中杂志, 2014, 9(7):600-604.
15.	Berthet K, Lavergne T, Cohen A, et al. Significant association of atrial vulnerability with atrial septal abnormalities in young patients with ischemic stroke of unknown cause[J]. Stroke, 2000, 31(2):398-403.

1. Mesa D, Ruiz M, Delgado M, et al. Preva lence of patent foramen ovale determined by transesophageal echocardiography in patients with cryptogenic stroke aged 55 years or older. Same as younger patients[J]. Rev Esp Cardiol, 2010, 63(3):315-322.
2. González-Alujas T, Evangelista A, Santamarina E, et al. Diagnosis and quantification of patent foramen ovale. Which is the reference technique? Simultaneous study with transcranial Doppler, transthoracic and transesophageal echocardiography[J]. Rev Esp Cardiol, 2011, 64(2):133-139.
3. Komar M, Olszowska M, Przewłocki T, et al. Transcranial doppler ultrasonography should it be the first choice for persistent foramen ovale screening?[J]. Cardiovasc Ultrasound, 2014, 12:16.
4. Zito C, Dattilo G, Oreto G, et al. Patent foramen ovale:comparison among diagnostic strategies in cryptogenic stroke and migraine[J]. Echocardiography, 2009, 26(5):495-503.
5. Agustin SJ, Yumul MP, Kalaw AJ, et al. Effects of posture on right-to-left shunt detection by contrast transcranial doppler[J]. Stroke, 2011, 42(8):2201-2205.
6. Shariat A, Yaghoubi E, Nemati R, et al. Comparison of agitated saline mixed with blood to agitated saline alone in detecting right-to-left shunt during contrast-transcranial Doppler sonography examination[J]. Acta Neurol Taiwan, 2011, 20(3):182-187.
7. Droste DW, Jekentaite R, Stypmann J, et al. Contrast transcranial Doppler ultrasound in the detection of right-to-left shunts:comparison of Echovist-200 and Echovist-300, timing of the Valsalva maneuver, and general recommendations for the performance of the test[J]. Cerebrovasc Dis, 2002, 13(4):235-241.
8. Basic identification criteria of Doppler microembolic signals. Consensus Committee of the Ninth International Cerebral Hemodynamic Symposium[J]. Stroke, 1995, 26(6):1123.
9. Jauss M, Zanette E. Detection of right-to-left shunt with ultrasound contrast agent and transcranial Doppler sonography[J]. Cerebrovasc Dis, 2000, 10(6):490-496.
10. TelmanG, Yalonetsky S, Kouperberg E, et al. Size of pfo and amount of microembolic signals in patients with ischaemic stroke or TIA[J]. Eur J Neurol, 2008, 15(9):969-972.
11. 杜微, 宋晓南, 杨戈, 等. 先天性卵圆孔未闭与缺血性卒中的最新研究进展[J]. 中风与神经疾病杂志, 2012, 29(7):669-672.
12. Calvet D, Mas JL. Closure of patent foramen ovale in cryptogenic stroke:a never ending story[J]. Cerr Opin Neurol, 2014, 27(1):13-19.
13. Overell JR, Bone I, Lees KR. Interatrial septal abnormalities and stroke:a meta-analysis of case-control studies[J]. Neurology, 2000, 55(8):1172-1179.
14. 杨方, 韩军良. 卵圆孔未闭所致脑栓塞1例报告[J]. 中国卒中杂志, 2014, 9(7):600-604.
15. Berthet K, Lavergne T, Cohen A, et al. Significant association of atrial vulnerability with atrial septal abnormalities in young patients with ischemic stroke of unknown cause[J]. Stroke, 2000, 31(2):398-403.

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