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1.
Rev Bras Ter Intensiva ; 31(2): 262-265, 2019 May 30.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31166560

RESUMO

Cardiac trauma often occurs in motor vehicle accidents. A 50-year-old female driver was transported to our hospital with multiple trauma after a high-speed car accident. After admission to the intensive care unit, cardiac ultrasound examination revealed traumatic tricuspid valve papillary muscle rupture and patent foramen ovale, while Lancisi's sign was noted on physical examination. Surgical treatment was performed with valve annuloplasty and closure of the patent foramen ovale and a covert right atrial defect that was detected intraoperatively.


Assuntos
Forame Oval Patente/etiologia , Átrios do Coração/cirurgia , Músculos Papilares/lesões , Valva Tricúspide/lesões , Acidentes de Trânsito , Anuloplastia da Valva Cardíaca/métodos , Feminino , Forame Oval Patente/diagnóstico , Forame Oval Patente/cirurgia , Átrios do Coração/lesões , Traumatismos Cardíacos/diagnóstico , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/cirurgia , Humanos , Pessoa de Meia-Idade , Músculos Papilares/cirurgia , Valva Tricúspide/cirurgia
2.
Expert Rev Med Devices ; 16(3): 173-182, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30741039

RESUMO

INTRODUCTION: The patent foramen ovale (PFO) is a common anatomical variant in humans (prevalence 25%). Most often asymptomatic, it may engender paradoxically embolic strokes, myocardial infarctions, or visceral or peripheral ischemia. It is causatively related to migraine, positional or exertional hypoxemia with dyspnea, diving incidents, high altitude edema, and sleep apnea. Percutaneous closure of atrial septal defects was first performed in the seventies. A dedicated PFO occluder (Amplatzer PFO Occluder) was first used on 10 September 1997 by Kurt Amplatz and Bernhard Meier. Since, percutaneous PFO closure has evolved into one of the most common and the simplest and safest catheter-based intervention in adult cardiology. Randomized studies have proved its benefit for prevention of recurrent ischemic events (particularly strokes) in patients without competing stroke etiology. There are also supportive clinical data for PFO closure in other situations. Areas covered: The Amplatzer PFO Occluder, the first, most implanted, and best-studied PFO occluder, is reviewed, presenting implantation technique, possible complications, and pertinent scientific data of efficacy and safety. Expert commentary: Percutaneous PFO closure has grown to one of the most common procedures in interventional cardiology. Implantation of the Amplatzer PFO Occluder is simple, safe, and effective.


Assuntos
Forame Oval Patente/cirurgia , Dispositivo para Oclusão Septal/efeitos adversos , Seguimentos , Forame Oval Patente/etiologia , Humanos , Resultado do Tratamento
3.
J Neurol Sci ; 392: 122-125, 2018 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-30055383

RESUMO

PURPOSE: We developed a novel probe (pastable soft ultrasound probe; PSUP) attached to the neck for right-to-left shunt (RLS) detection. The purpose of this study was to evaluate the diagnostic ability of the PSUP for RLS detection by comparison with transesophageal echocardiography (TEE). METHODS: The subjects were patients with ischemic strokes and transient ischemic attacks who underwent TEE. Based on TEE, patients with patent foramen ovale (PFO) were divided into two groups by the number of microbubbles (MBs): small PFO (1-29 MBs) and large PFO (≥30 MBs). Then, PSUP examination of one common carotid artery (CCA) was started using a procedure similar to TEE. RLS was diagnosed by PSUP when one or more microembolic signals were found in the CCA. The detection rate by size of PFO was compared between TEE and PSUP, and the diagnostic accuracy of PSUP was calculated. RESULTS: From May 2014 to July 2016, 84 patients (63 males, median age 63 years) were included; 41 (49%) were diagnosed with PFO by TEE, while PSUP detected PFO in 31 (37%). Using TEE findings as the reference, PSUP for PFO showed sensitivity of 68%, specificity of 93%, and accuracy of 81%. On TEE, 22 patients had large PFOs, and 19 patients had small PFOs. The PSUP could identify large PFOs in grade I and II of International Consensus Criteria more accurately than small ones (58 and 86% vs. 29 and 14%, P = 0.003). CONCLUSIONS: The PSUP has considerable accuracy for diagnosing large PFOs. PSUP should play an important role in detecting large PFOs.


Assuntos
Ecocardiografia Transesofagiana/métodos , Forame Oval Patente/diagnóstico por imagem , Ultrassonografia Doppler Transcraniana/métodos , Idoso , Meios de Contraste/metabolismo , Feminino , Forame Oval Patente/etiologia , Humanos , Ataque Isquêmico Transitório/complicações , Masculino , Pessoa de Meia-Idade , Pescoço/diagnóstico por imagem , Ultrassonografia Doppler Transcraniana/instrumentação , Manobra de Valsalva/fisiologia
5.
Int J Stroke ; 13(3): 240-242, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29299960

RESUMO

Contrasting with three randomized trials that failed to show any superiority of patent foramen ovale closure over antithrombotic therapy, two trials recently reported lower rates of stroke recurrence among patients assigned to patent foramen ovale closure than among those assigned to antiplatelet therapy. In addition, one of the initially negative trials concluded in favor of patent foramen ovale closure after an extended follow-up period. A better selection of patients, the use of reference treatment groups that included patients who received antiplatelet therapy alone (rather than antiplatelet drugs or oral anticoagulants, according to physician preference), and a longer follow-up of patients, may explain the divergent findings across studies. Procedural complications were reported in 1.5% to 5.9% of the patients, none of which led to permanent disability or death. Patent foramen ovale closure was associated with an increased risk of new-onset atrial fibrillation in several studies and of venous thromboembolism in one study.


Assuntos
Forame Oval Patente/etiologia , Acidente Vascular Cerebral/complicações , Humanos
6.
BMC Pregnancy Childbirth ; 18(1): 8, 2018 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-29298686

RESUMO

BACKGROUND: Membranous ventricular septal aneurysm (MVSA) is a rare cardiac anomaly that can occur as an isolated entity or being associated with other cardiac malformations. Complications of MVSA include thromboembolism, arrhythmia, rupture, bacterial endocarditis, right ventricular outflow tract obstruction, and atrioventricular valve diseases.The success rate of pregnancy and delivery in patients with MVSA has not been reported in the literature. This study was to assess the clinical implications of this condition from our center's experience. METHODS: This was a retrospective study for consecutive 12 pregnancies in women with MVSA, who delivered at a tertiary care center in west China between May 2008 and March 2015. RESULTS: All patients with MVSA delivered via caesarian section. One patient with severe pulmonary arterial hypertension expired from pulmonary infection and heart failure after delivery. One patient terminated pregnancy in the second trimester- necessitated by cardiogenic shock. The other mothers had varying degrees of cardiac morbidity, but survived. Ten of thirteen newborns survived. Congenital heart disease and small-for-gestational-age (SGA) of newborn occurred in two cases (one twin and one single gestation). Two of these babies expired. CONCLUSIONS: Maternal and neonatal risk appeared associated with heart functional classifications, pulmonary hypertension and histories of cardiac events such as serious cardiac arrhythmia. Accurate diagnosis and care by a multidisciplinary team is recommended for pregnant woman with MVSA.


Assuntos
Comunicação Interventricular/complicações , Comunicação Interventricular/terapia , Complicações Cardiovasculares na Gravidez/terapia , Adolescente , Adulto , Cesárea , Permeabilidade do Canal Arterial/etiologia , Ecocardiografia , Feminino , Forame Oval Patente/etiologia , Comunicação Interventricular/diagnóstico por imagem , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Morte Materna/etiologia , Morte Perinatal/etiologia , Gravidez , Complicações Cardiovasculares na Gravidez/diagnóstico por imagem , Estudos Retrospectivos , Tetralogia de Fallot/etiologia , Adulto Jovem
7.
Headache ; 58(1): 173-183, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28181217

RESUMO

BACKGROUND: A growing body of literature suggests that migraineurs, particularly those with aura, have an increased risk for ischemic stroke, but not via enhanced atherosclerosis. The theory that micro-emboli induced ischemia provokes cortical spreading depression (ie, symptomatic aura) in migraineurs but transient ischemic attacks in others highlights a potential role for hypercoagulability as a link between migraine (with aura) and stroke. AIM: Our objective is to summarize the literature evaluating the association of migraine with various acquired or inheritable thrombophilic states, including those related to elevated estrogen levels, endothelial activation and dysfunction, antiphospholipid antibodies (aPL), deficiency of coagulation inhibitors, and presence of certain genetic polymorphisms. FINDINGS: Although definitive studies are lacking, a preponderance of available evidence links migraine, and especially aura, to increased levels of estradiol (eg, oral contraceptive pill [OCP] use, pregnancy), thrombo- and erythrocytosis, von Willebrand factor (vWF) antigen, fibrinogen, tissue plasminogen activator (tPA) antigen, and endothelial microparticles. Studies of a link to migraine are conflicting for aPL, homocysteine, Protein S, and the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism. No association with migraine was found in meta-analyses of Factor V Leiden, and of prothrombin gene mutation. Within a large, young ischemic stroke sample, migraine with aura was associated with a thrombophilic state and with patent foramen ovale (PFO). In the non-stroke population, meta-analyses show an association of PFO and migraine with aura (MA), but two population-based studies do not support the link. RECOMMENDATIONS: For persons with MA and (1) a personal history or family history of thrombosis, or (2) MRI evidence of micro-vascular ischemia or of stroke, an evaluation for hypercoagulability is warranted. In cases of MA alone, consider screening for markers of endothelial activation (eg, vWF, high sensitivity c-reactive protein [hs CRP], and fibrinogen). Rigorous management of other stroke risk factors is paramount, but efficacy of anti-thrombotic agents in the treatment of migraine is unproven. Closure of PFO is not routinely recommended based on negative randomized trials.


Assuntos
Transtornos de Enxaqueca/complicações , Trombofilia/complicações , Anticorpos/metabolismo , Estrogênios/metabolismo , Forame Oval Patente/etiologia , Humanos , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Metilenotetra-Hidrofolato Redutase (NADPH2)/metabolismo , Transtornos de Enxaqueca/genética , Mutação/genética , Fosfolipídeos/imunologia , Fatores de Risco , Trombofilia/genética
8.
Respir Med ; 129: 31-38, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28732833

RESUMO

Platypnea-Orthodeoxia syndrome (POS) is a rare clinical entity characterized by dyspnea and arterial desaturation while in the upright position. The various pathophysiologic mechanisms leading to POS has puzzled clinicians for years. The hypoxia in POS has been attributed to the mixing of the deoxygenated venous blood with the oxygenated arterial blood via a shunt. The primary mechanisms of POS in these patients can be broadly classified based on intracardiac abnormalities, extracardiac abnormalities and miscellaneous etiologies. A Patent Foramen Ovale (PFO) was the most common reported site of an intracardiac shunt. In addition to PFO, intracardiac shunt leading to POS has been reported from either an Atrial Septal Defect (ASD) or an Atrial Septal Aneurysm (ASA). Most patients with an intracardiac shunt also demonstrated a secondary anatomic or a functional defect. Extracardiac causes of POS included intra-pulmonary arteriovenous malformations and lung parenchymal diseases. A systematic evaluation is necessary to identify the underlying cause and institute an appropriate intervention. We conducted a review of literature and reviewed 239 cases of POS. In this article, we review the etiology and pathophysiology of POS and also summarize the diagnostic algorithms and treatment modalities available for early diagnosis and prompt treatment of patients presenting with symptoms of platypnea and/or orthodeoxia.


Assuntos
Dispneia/diagnóstico , Forame Oval Patente/complicações , Comunicação Interatrial/complicações , Síndrome Hepatopulmonar/complicações , Hipóxia/diagnóstico , Pulmão/irrigação sanguínea , Dispneia/etiologia , Dispneia/fisiopatologia , Dispneia/terapia , Forame Oval Patente/diagnóstico , Forame Oval Patente/etiologia , Forame Oval Patente/cirurgia , Comunicação Interatrial/diagnóstico , Comunicação Interatrial/epidemiologia , Comunicação Interatrial/cirurgia , Síndrome Hepatopulmonar/diagnóstico , Síndrome Hepatopulmonar/epidemiologia , Humanos , Hipóxia/etiologia , Hipóxia/fisiopatologia , Hipóxia/terapia , Pulmão/anormalidades , Pulmão/patologia , Tecido Parenquimatoso/patologia , Postura/fisiologia
9.
Echocardiography ; 34(5): 782-785, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28295572

RESUMO

Dyspnea and hypoxemia are common postoperative problems after pneumonectomy. One of the rarer causes of respiratory distress after right pneumonectomy is the development of a significant right-to-left shunt across a patent foramen ovale (PFO), which can evolve at a variable interval of time after the operation. We report here our experience with a patient who underwent right pneumonectomy, followed by several complications, and who presented severe dyspnea 7 months later, after the closure of a right thoracostomy. This report outlines the management of this challenging clinical condition; transesophageal echocardiography (TOE) provided a clear diagnosis and guided an effective percutaneous treatment.


Assuntos
Dispneia/etiologia , Ecocardiografia/métodos , Forame Oval Patente/diagnóstico por imagem , Forame Oval Patente/terapia , Pneumonectomia/efeitos adversos , Toracostomia/efeitos adversos , Técnicas de Fechamento de Ferimentos/efeitos adversos , Diagnóstico Diferencial , Dispneia/diagnóstico , Dispneia/prevenção & controle , Dispneia/terapia , Forame Oval Patente/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Raras/diagnóstico , Doenças Raras/etiologia , Doenças Raras/terapia , Resultado do Tratamento
10.
Physiol Rep ; 5(6)2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28325788

RESUMO

Hypovolemia is known to be a predisposing factor of decompression illness (DCI) while diving. The typical clinically impressive neurological symptoms of DCI may distract from other symptoms such as an incipient hypovolemic shock. We report the case of a 61-year-old male Caucasian, who presented with an increasing central and peripheral neural failure syndrome and massive hypovolemia after two risky dives. Computed tomography (CT) scans of the chest and Magnetic resonance imaging scans of the head revealed multiple cerebral and pulmonary thromboembolisms. Transesophageal echocardiography showed a patent foramen ovale (PFO). Furthermore, the patient displayed hypotension as well as prerenal acute kidney injury with elevated levels of creatinine and reduced renal clearance, indicating a hypovolemic shock. Early hyperbaric oxygen (HBO) therapy reduced the neurological deficits. After volume expansion of 11 liters of electrolyte solution (1000 mL/h) the cardiopulmonary and renal function normalized. Hypovolemia increases the risk of DCI during diving and that of hypovolemic shock. Early HBO therapy and fluid replacement is crucial for a favorable outcome.


Assuntos
Lesão Renal Aguda/etiologia , Encéfalo/diagnóstico por imagem , Doença da Descompressão/etiologia , Mergulho/efeitos adversos , Forame Oval Patente/etiologia , Oxigenação Hiperbárica , Choque/etiologia , Lesão Renal Aguda/sangue , Lesão Renal Aguda/diagnóstico por imagem , Lesão Renal Aguda/terapia , Creatinina/sangue , Doença da Descompressão/sangue , Doença da Descompressão/diagnóstico por imagem , Doença da Descompressão/terapia , Forame Oval Patente/sangue , Forame Oval Patente/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Substitutos do Plasma , Choque/sangue , Choque/diagnóstico por imagem , Choque/terapia , Resultado do Tratamento
11.
Can J Cardiol ; 31(8): 1061-6, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26143138

RESUMO

Patent foramen ovale (PFO) is associated with an increased risk of decompression sickness (DCS) in divers that results from a paradoxical embolization of nitrogen bubbles. The number of scuba divers worldwide is estimated in the millions, and the prevalence of PFO is 25%-30% in adults. It is interesting that despite these numbers, many important issues regarding optimal screening, risk stratification, and management strategy still remain to be resolved. Recently published data suggest the possible effectiveness of both PFO closure and conservative diving measures in preventing arterial gas embolization. This review aims to introduce the basic principles of physiology and the pathophysiology of bubble formation and DCS, summarize the current literature on PFO and diving, and review the possibilities of diagnostic workup and management.


Assuntos
Doença da Descompressão/complicações , Mergulho/efeitos adversos , Forame Oval Patente/epidemiologia , Forame Oval Patente/etiologia , Recreação , Adulto , Saúde Global , Humanos , Incidência , Fatores de Risco
12.
Crit Care ; 19: 174, 2015 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-25887151

RESUMO

INTRODUCTION: Acute cor pulmonale (ACP) and patent foramen ovale (PFO) remain common in patients under protective ventilation for acute respiratory distress syndrome (ARDS). We sought to describe the hemodynamic profile associated with either ACP or PFO, or both, during the early course of moderate-to-severe ARDS using echocardiography. METHODS: In this 32-month prospective multicenter study, 195 patients with moderate-to-severe ARDS were assessed using echocardiography during the first 48 h of admission (age: 56 (SD: 15) years; Simplified Acute Physiology Score: 46 (17); PaO2/FiO2: 115 (39); VT: 6.5 (1.7) mL/kg; PEEP: 11 (3) cmH2O; driving pressure: 15 (5) cmH2O). ACP was defined by the association of right ventricular (RV) dilatation and systolic paradoxical ventricular septal motion. PFO was detected during a contrast study using agitated saline in the transesophageal bicaval view. RESULTS: ACP was present in 36 patients, PFO in 21 patients, both PFO and ACP in 8 patients and the 130 remaining patients had neither PFO nor ACP. Patients with ACP exhibited a restricted left ventricle (LV) secondary to RV dilatation and had concomitant RV dysfunction, irrespective of associated PFO, but preserved LV systolic function. Despite elevated systolic pulmonary artery pressure (sPAP), patients with isolated PFO had a normal RV systolic function. sPAP and PaCO2 levels were significantly correlated. CONCLUSIONS: In patients under protective mechanical ventilation with moderate-to-severe ARDS, ACP was associated with LV restriction and RV failure, whether PFO was present or not. Despite elevated sPAP, PFO shunting was associated with preserved RV systolic function.


Assuntos
Forame Oval Patente/etiologia , Hemodinâmica , Doença Cardiopulmonar/etiologia , Síndrome do Desconforto Respiratório do Adulto/fisiopatologia , Adulto , Idoso , Ecocardiografia , Feminino , Forame Oval Patente/diagnóstico , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Doença Cardiopulmonar/diagnóstico , Respiração Artificial
13.
Neurol Neurochir Pol ; 49(1): 45-51, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25666773

RESUMO

The diver's nervous system is extremely sensitive to high ambient pressure, which is the sum of atmospheric and hydrostatic pressure. Neurological complications associated with diving are a difficult diagnostic and therapeutic challenge. They occur in both commercial and recreational diving and are connected with increasing interest in the sport of diving. Hence it is very important to know the possible complications associated with this kind of sport. Complications of the nervous system may result from decompression sickness, pulmonary barotrauma associated with cerebral arterial air embolism (AGE), otic and sinus barotrauma, high pressure neurological syndrome (HPNS) and undesirable effect of gases used for breathing. The purpose of this review is to discuss the range of neurological symptoms that can occur during diving accidents and also the role of patent foramen ovale (PFO) and internal carotid artery (ICA) dissection in pathogenesis of stroke in divers.


Assuntos
Barotrauma/etiologia , Dissecação da Artéria Carótida Interna/etiologia , Mergulho/efeitos adversos , Forame Oval Patente/etiologia , Síndrome Neurológica de Alta Pressão/etiologia , Narcose por Gás Inerte/etiologia , Humanos
14.
J Clin Neurosci ; 22(4): 767-8, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25709056

RESUMO

We report a young woman who survived multiple cerebral infarctions related to an amniotic fluid embolism (AFE) during labor. To our knowledge, an embolic stroke due to the coexistence of an AFE and patent foramen ovale (PFO) has not been reported. We describe the patient's clinical and radiological features and discuss the stroke mechanism in relation to our AFE hypothesis. A 32-year-old woman presented to the emergency room after experiencing convulsions during labor (blood pressure, 64/28mmHg; oxygen saturation, 67%). She was in a stupor, and her response to painful stimuli on the right side was weaker than on the left side. Acute stroke was considered as a possible cause. Additionally, an AFE was suspected due to cardiopulmonary arrest during labor. Brain MRI revealed multiple territory embolic infarctions. The transcranial Doppler with bubble study demonstrated a right-to-left shunt during the Valsalva maneuver. A transesophageal echocardiogram revealed a PFO with a right-to-left shunt. The elevated intrathoracic pressure during labor may have caused blood to flow backward through the heart, shunting blood from the right side to the left through the PFO. In cases such as this, an amniotic fluid embolus may travel directly from the venous to the arterial circulation via the PFO, leading to multiple cerebral infarctions.


Assuntos
Isquemia Encefálica/etiologia , Embolia Amniótica , Forame Oval Patente/etiologia , Parto , Acidente Vascular Cerebral/etiologia , Adulto , Ecocardiografia Transesofagiana , Feminino , Humanos , Imagem por Ressonância Magnética , Gravidez , Manobra de Valsalva
15.
Perfusion ; 30(5): 400-2, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25249517

RESUMO

Two patients presented in profound respiratory distress unresponsive to maximal support and were placed on venovenous ECMO. Subsequently, both were found to have a patent foramen ovale and high pulmonary artery pressures, resulting in a right to left shunt. Both patients had a better than expected response to ECMO, likely related to their shunts allowing oxygenated blood to bypass the high pulmonary artery pressures and go directly to the left heart. Both patients were successfully weaned from ECMO and discharged to home in good condition.


Assuntos
Oxigenação por Membrana Extracorpórea/métodos , Forame Oval Patente/terapia , Síndrome do Desconforto Respiratório do Adulto/terapia , Adulto , Idoso , Pressão Arterial , Feminino , Forame Oval Patente/etiologia , Forame Oval Patente/fisiopatologia , Humanos , Masculino , Artéria Pulmonar/fisiopatologia , Síndrome do Desconforto Respiratório do Adulto/etiologia , Síndrome do Desconforto Respiratório do Adulto/fisiopatologia
18.
Eur J Neurol ; 21(3): 525-8, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24444328

RESUMO

BACKGROUND AND PURPOSE: Data on the possible association between cardiac right-to-left shunt (RLS) and cryptogenic stroke are lacking in Asians. RLS and its subtypes in Chinese cryptogenic stroke patients were investigated. METHODS: Patients (n = 153, mean age 42 ± 10 years, 81 male) with cryptogenic stroke from four medical centers in China and 135 healthy volunteers (mean age 34 ± 8 years, 54 male) were recruited. Contrast transcranial Doppler was used to assess the prevalence of RLS. A three-level RLS categorization was applied as follows: none, 0 microbubbles (MBs); small, 1-25 MBs; and large, >25 MBs. RLS was considered latent if it occurred only after the Valsalva maneuver or permanent when it occurred also during normal respiration. RESULTS: Overall, RLS (P = 0.02), large RLS (P < 0.001) and permanent RLS (P = 0.02) were more frequently detected in patients with cryptogenic stroke than in healthy volunteers. The prevalences of small RLS and latent RLS in the two groups were similar (22% vs. 21% and 11% vs. 10%, respectively). The proportion of large RLSs amongst the subjects with RLS was much higher in the patient group than in healthy volunteers (45% vs. 18%, P < 0.001), whilst the proportion of permanent RLS was similar (72% vs. 64%, P = 0.11). Most large RLSs in the patient group (22/27, 81%) were permanent RLSs. CONCLUSIONS: Cardiac RLS is associated with cryptogenic stroke in Chinese. However, the higher prevalence of overall RLS in the patient group was mainly due to the increased proportion of large RLSs. The results only support large RLSs as a pathological condition.


Assuntos
Derivação Arteriovenosa Cirúrgica/métodos , Forame Oval Patente/cirurgia , Acidente Vascular Cerebral/cirurgia , Adulto , Grupo com Ancestrais do Continente Asiático , Estudos de Casos e Controles , Feminino , Forame Oval Patente/diagnóstico por imagem , Forame Oval Patente/etiologia , Lateralidade Funcional , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico por imagem , Ultrassonografia Doppler Transcraniana , Adulto Jovem
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