title: Elevated left ventricular end-diastolic pressure favours closure of foramen ovale.
abstract: OBJECTIVE
  It has been described that prevalence of patent foramen ovale (PFO) declines with age. Our hypothesis was that persistent high pressures in the left atria (LA), may facilitate closure of PFO and age would not play a role.
  
  
  RESULTS
  The prevalence of PFO was studied in 201 consecutive patients with suspicion of cardioembolic stroke by contrast transoesophageal echocardiography. Left ventricular end-diastolic pressures (LVEDP) were estimated non-invasively by transthoracic echocardiography. Patients with normal diastolic function (DF) or with diastolic dysfunction (DD) stage I were considered as having normal LVEDP whereas patients with DD stage II or III as having elevated LVEDP. Prevalence of PFO was 42.8% and it was smaller in patients with elevated LVEDP than in patients with normal LVEDP (21.2% vs. 51.7%, P < 0.01). There was a smaller prevalence of PFO in patients with DD stage II than in patients with DD stage I or normal DF (25% vs. 51 and 54%, both P < 0.05). Size of the LA was larger in patients without PFO [34.73 ml/m2 (24.14-40.84ml/m2) vs. 27.86 ml/m2 (21.37-34.68 ml/m2), P < 0.05]. Mean age was 64.2 years (57.38-75.77) with no difference between patients with PFO and without PFO. In multivariate analysis Eustachian valve, atrial septal aneurysm, elevated LVEDP and large LA remained significantly associated (P < 0.05) with PFO.
  
  
  CONCLUSIONS
  Elevated LVEDP and enlargement of LA are negatively associated with PFO. The higher the LVEDP, the lower the prevalence of PFO. Age is not associated with PFO.
authors: Department of Cardiology and Angiology, University Hospital Muenster, Germany. flandeta@yahoo.com.ar
authors: Federico
authors: F
authors: Landeta
authors: Elmar
authors: E
authors: von dem Bussche
authors: Martin
authors: M
authors: Ritter
authors: Kristina
authors: K
authors: Boentert
authors: Johannes
authors: J
authors: Waltenberger
authors: Joerg
authors: J
authors: Stypmann
mesh_terms: D000368:Aged; D003971:Diastole; D018450:Disease Progression; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D054085:Foramen Ovale / Q000000981:diagnostic imaging / Q000502:physiology*; D054092:Foramen Ovale, Patent / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D020127:Recovery of Function; D017725:Ventricular Pressure / Q000502:physiology*