Detection of patent foramen ovale in patients with ischemic stroke on prospective ECG-gated cardiac CT compared to transthoracic echocardiography
العنوان: | Detection of patent foramen ovale in patients with ischemic stroke on prospective ECG-gated cardiac CT compared to transthoracic echocardiography |
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المؤلفون: | L. A. Rinkel, B. J. Bouma, S. M. Boekholdt, C. F. P. Beemsterboer, N. H. J. Lobé, L. F. M. Beenen, H. A. Marquering, C. B. L. M. Majoie, Y. B. W. E. M. Roos, A. van Randen, R. N. Planken, J. M. Coutinho |
المساهمون: | Radiology and nuclear medicine, ACS - Atherosclerosis & ischemic syndromes, Cardiology, ACS - Heart failure & arrhythmias, ACS - Pulmonary hypertension & thrombosis, Radiology and Nuclear Medicine, ACS - Microcirculation, ANS - Neurovascular Disorders, Biomedical Engineering and Physics, ANS - Brain Imaging, Neurology |
المصدر: | Rinkel, L A, Bouma, B J, Boekholdt, S M, Beemsterboer, C F P, Lobé, N H J, Beenen, L F M, Marquering, H A, Majoie, C B L M, Roos, Y B W E M, van Randen, A, Planken, R N & Coutinho, J M 2023, ' Detection of patent foramen ovale in patients with ischemic stroke on prospective ECG-gated cardiac CT compared to transthoracic echocardiography ', Journal of Neurology, vol. 270, no. 7, pp. 3537-3542 . https://doi.org/10.1007/s00415-023-11688-0 Journal of Neurology. D. Steinkopff-Verlag Journal of neurology. D. Steinkopff-Verlag |
سنة النشر: | 2023 |
مصطلحات موضوعية: | Stroke, Neurology, Cardioembolism, Echocardiography, Neurology (clinical), Patent foramen ovale, CT |
الوصف: | Background Cardiac CT acquired during the acute stroke imaging protocol is an emerging alternative to transthoracic echocardiography (TTE) to screen for sources of cardioembolism. Currently, its diagnostic accuracy to detect patent foramen ovale (PFO) is unclear. Methods This was a substudy of Mind the Heart, a prospective cohort in which consecutive adult patients with acute ischemic stroke underwent prospective ECG-gated cardiac CT during the initial stroke imaging protocol. Patients also underwent TTE. We included patients Results Of 452 patients in Mind the Heart, 92 were younger than 60 years. Of these, 59 (64%) patients underwent both cardiac CT and cTTE and were included. Median age was 54 (IQR 49–57) years and 41/59 (70%) were male. Cardiac CT detected a PFO in 5/59 (8%) patients, 3 of which were confirmed on cTTE. cTTE detected a PFO in 12/59 (20%) patients. Sensitivity and specificity of cardiac CT were 25% (95% CI 5–57%) and 96% (95% CI 85–99%), respectively. Positive and negative predictive values were 59% (95% CI 14–95) and 84% (95% CI 71–92). Conclusion Prospective ECG-gated cardiac CT acquired during the acute stroke imaging protocol does not appear to be a suitable screening method for PFO due to its low sensitivity. Our data suggest that if cardiac CT is used as a first-line screening method for cardioembolism, additional echocardiography remains indicated in young patients with cryptogenic stroke, in whom PFO detection would have therapeutic consequences. These results need to be confirmed in larger cohorts. |
اللغة: | English |
تدمد: | 0340-5354 |
URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1f139ba2b9e8a62494272583560e844e https://research.vumc.nl/en/publications/dc02b2ae-c012-42cf-856b-eed5f047d8ec |
حقوق: | OPEN |
رقم الأكسشن: | edsair.doi.dedup.....1f139ba2b9e8a62494272583560e844e |
قاعدة البيانات: | OpenAIRE |
تدمد: | 03405354 |
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