Analysis of fossa ovalis membrane velocities by transesophageal Doppler tissue echocardiography: a novel approach to functional assessment of patent foramen ovale.
BACKGROUND
Recent studies have suggested that a higher mobility of the fossa ovalis membrane (FOM) may be associated with an increased risk for stroke in patients with patent foramen ovale (PFO). The current study analyzed whether Doppler tissue echocardiography is useful for quantitation of FOM motion velocities.


METHODS
FOM dynamics were prospectively studied in 107 consecutive patients (average age 50.7 +/- 15.3 years, 48 men) with in sinus rhythm who underwent transesophageal echocardiography for various indications. With pulsed wave Doppler tissue echocardiography interrogation, a characteristic quadrophasic signal was recorded in all patients, consisting of a positive wave toward the left atrium (A-wave) at late diastole, followed by a negative wave (B-wave) toward the right atrium, a pronounced, again positive wave during midsystole (C-wave), and a final negative wave (D-wave).


RESULTS
Peak velocities of A-wave, B-wave, C-wave, and D-wave were 0.08 +/- 0.02 m/s, 0.11 +/- 0.05 m/s, 0.17 +/- 0.07 m/s, and 0.14 +/- 0.06 m/s, respectively. In 21 of 107 (19.6%) patients, PFO was detected. Patients with PFO had significantly higher C-wave and D-wave peak velocities compared with the 86 patients without PFO (0.23 +/- 0.10 m/s vs 0.15 +/- 0.05 m/s, P < .001 and 0.16 +/- 0.07 m/s vs 0.12 +/- 0.06 m/s, P = .04, respectively).


CONCLUSIONS
Assessment of FOM dynamics using Doppler tissue echocardiography is feasible. It allows definition of a characteristic quadrophasic FOM motion pattern, thereby providing new insights into the physiology of FOM mobility. Patients with PFO were found to have increased FOM mobility compared with patients without PFO.
Eggebrecht
Holger
H
West German Heart Center, Department of Cardiology, University of Duisburg-Essen, Essen, Germany. holger.eggebrecht@uni-essen.de
Naber
Christoph K
CK
Plato
Christiane
C
Erbel
Raimund
R
Bartel
Thomas
T
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003287:Contrast Media; D018619:Echocardiography, Doppler, Pulsed; D017548:Echocardiography, Transesophageal; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
D003287:Contrast Media