Prevalence of patent foramen ovale determined by transesophageal echocardiography in patients with cryptogenic stroke aged 55 years or older. Same as younger patients?
OBJECTIVE
To investigate the relationship between patent foramen ovale and cryptogenic stroke in patients aged > or =55 years.


METHODS
This prospective study determined the presence of patent foramen ovale and atrial septal aneurysm using transesophageal echocardiography in 262 consecutive patients with a diagnosis of probable cryptogenic stroke. Data from 44 patients aged > or =55 years with cryptogenic stroke (Group A) were compared with those from two other groups: 194 patients aged <55 years with cryptogenic stroke (Group B) and 24 control patients aged > or =55 years with stroke of known origin, namely grade III-V aortic atheromatosis (Group C).


RESULTS
The frequency of patent foramen ovale in Group A was similar to that in Group B (38% vs. 36%; P=.85) but significantly higher than that in Group C (38% vs. 8%; P=.029). The frequency of patent foramen ovale with concomitant atrial septal aneurysm was significantly higher in the study group (Group A) than in the control Group C (18% vs. 0; P=.039) and non-significantly higher than in Group B (18% vs. 11%; P=.11).


CONCLUSIONS
The frequency of patent foramen ovale alone or in association with atrial septal aneurysm in patients with cryptogenic stroke aged > or =55 years was similar to that in those aged <55 years, but higher than that in patients aged > or =55 years with stroke of atherosclerotic origin. These data suggest that paradoxical embolism could be a cause of stroke in both age groups.
Mesa
Dolores
D
Servicio de Cardiologia, Hospital Universitario Reina Sofia, Cordoba, Spain. dmesar@ya.com
Ruiz
Martín
M
Delgado
Mónica
M
Suárez de Lezo
José
J
Pan
Manuel
M
Tejero
Ignacio
I
García
Daniel
D
Crespín
Manuel
M
León
Carmen
C
Toledano
Francisco
F
Mazuelos
Francisco
F
Ochoa
Juan J
JJ
Bescansa
Enrique
E
D000328:Adult; D000367:Age Factors; D017548:Echocardiography, Transesophageal; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D020521:Stroke / Q000150:complications*