Migraineurs with patent foramen ovale have larger right-to-left shunt despite similar atrial septal characteristics.
The objective of the study was to assess differences in proportion of large right-to-left shunt (RLS) and atrial septal characteristics between migraineurs and non-migraineurs referred for transcatheter closure of patent foramen ovale (PF0). This retrospective study took place in a large metropolitan medical centre. The patients were migraineurs with aura (n=52), migraineurs without aura (n=19) and non-migraineurs (n=149). RLS was evaluated before closure using bilateral power m-mode transcranial Doppler at rest and after calibrated, sustained Valsalva manoeuvre, and graded with a validated 0-5 scale. Intracardiac echocardiography was used to assess atrial septal characteristics. Migraineurs had a higher proportion of large RLS (Grade IV or V) than nonmigraineurs at rest and after calibrated Valsalva (rest, p=0.04; Valsalva, p=0.01). Atrial septal characteristics were similar between groups. Migraine is associated with larger RLS at rest and strain; however migraine status does not predict PFO characteristics.
Jesurum
Jill T
JT
Department of Cardiovascular Research, Swedish Medical Center, Seattle, WA, USA. jill.jesurum@swedish.org
Fuller
Cindy J
CJ
Velez
Carles A
CA
Spencer
Merrill P
MP
Krabill
Kimberly A
KA
Likosky
William H
WH
Gray
William A
WA
Olsen
John V
JV
Reisman
Mark
M
D000328:Adult; D000368:Aged; D054087:Atrial Septum / Q000473:pathology / Q000503:physiopathology*; D001921:Brain / Q000098:blood supply / Q000503:physiopathology; D006348:Cardiac Surgical Procedures; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*; D020325:Migraine with Aura / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D012039:Regional Blood Flow / Q000502:physiology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial; D014636:Valsalva Maneuver / Q000502:physiology