Comparison of transthoracic echocardiography using second harmonic imaging, transcranial Doppler and transesophageal echocardiography for the detection of patent foramen ovale in stroke patients

Souteyrand, Géraud; Motreff, Pascal; Lusson, Jean-René; Rodriguez, R.J.; Geoffroy, Etienne; Dauphin, Claire; Boire, Jean-Yves; Lamaison, D; Cassagnes, J

doi:10.1016/j.euje.2005.04.007

Cited by 78 publications

(79 citation statements)

References 37 publications

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“…con ETT e imaging armonico [33]. Inoltre, in particolari situazioni quali sedazione del paziente e conseguente difficoltà ad eseguire la manovra di Valsalva, la sensibilità dell'ETE nell'identificazione del FOP potrebbe essere inferiore all'ETT "armonico" [34]. Per alcuni autori il riscontro mediante ecocontrastografia con ETT ed imaging armonico in giovani pazienti con stroke/TIA criptogenico di shunt renderebbe superfluo il ricorso all'ETE [35].…”

Section: Discussioneunclassified

Prevalence of aneurysm of the interatrial septum in the general population and in patients with a recent episode of cryptogenetic ischemic stroke: a tissue harmonic imaging transthoracic ecocardiography study in 5.631 patients

Serafini¹,

Misuraca²,

Siniscalchi³

et al. 2016

Monaldi Arch Chest Dis

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IntroduzioneL'ischemia cerebrale è tra le principali cause di mortalità e morbilità nei paesi industrializzati, essendo responsabile del 10-12% di tutti i decessi e di un elevato numero di invalidità permanenti [1]. Le forme cardioemboliche, secondarie a fibrillazione atriale (FA), cardiopatia ischemica, valvulopatia reumatica, protesi valvolari, cardiopatie congenite ed endocarditi sarebbero responsabili di circa il 30-35% delle sindromi cerebrovascolari acute [2]. Tuttavia in una significativa percentuale dei casi, soprattutto nei giovani, gli episodi ischemici cerebrali non sono riconducibili a nessuna di tali alterazioni: si parla in questi casi di Stroke / TIA criptogenici [3]. In tali pazienti sono state frequentemente segnalate anomalie cardiache rappresentate dall'aneurisma del setto interatriale (ASA) e dal forame ovale pervio (FOP) [4]. L'ASA è un'alterazione costituita da un'abnorme estroflessione del setto interatriale che coinvolge prevalentemente la regione della fossa ovale, ma che può interessare anche tutto il setto, con diversa morfologia in relazione al variare delle pressioni esistenti nelle cavità atriali, potendosi mostrare come una sacculazione sinistra o destra concava fissa o più frequentemente fasicamente mobile [5][6].L'ASA è un'entità ad oggi ancora non ben definita: non univoci ne sono i criteri diagnostici, incerta ne è la prevalenza in popolazioni non selezionate, non definitivamente chiarito è il suo ruolo nelle sindromi ischemiche cerebrali/sistemiche, nella sua Cerebral ischemia is among the principal causes of mortality and morbidity in industrialized countries being responsible of 10-12% of all deaths and of an elevated number of permanent disability. The cardioembolic forms may be responsible of the 30-35% of cerebrovascular acute syndrome, nevertheless in a significant percentage of cases, especially among young people, cerebral ischemic episodes are not induced by these cardiembolic forms: these cases are defined as cryptogenetic stroke/TIA. In these patients cardiac abnormalities represented by an aneurysm of the interatrial septum (ASA) and by a patent foramen ovale (PFO) have been frequently observed. The purpose of our prospective study was to evaluate, through transthoracic ecocardiography and tissue harmonic imaging (ETT-THI), the prevalence of ASA in the general population (group A) and the prevalence of ASA-FOP in a subgroup of patients with recent episode of cryptogenetic ischemic stroke/TIA (group B). We studied in a prospective manner from January 1 2003 to October 31t 2004 n. 5.631 patients. The presence of ASA was found in 3,2% of patients of group A, while in patients of group B we identifyed an ASA in 32% and a POF in 42% of the cases. Using a ETT-THI, our study shows in a wide range of a non selected population a prevalence of ASA greater than in previous studies. Such high prevalence in the general population of patients submitted to echocardiography and the higher frequency in subjects with recent cryptogenetic stroke, suggests to search carefully these ab...

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Section: Discussioneunclassified

Prevalence of aneurysm of the interatrial septum in the general population and in patients with a recent episode of cryptogenetic ischemic stroke: a tissue harmonic imaging transthoracic ecocardiography study in 5.631 patients

Serafini¹,

Misuraca²,

Siniscalchi³

et al. 2016

Monaldi Arch Chest Dis

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“…Aunque la ecocardiografía transesofágica con inyección de microburbujas (ETEc) sigue siendo considerada como su estándar de referencia, es sólo algo más sensible y es igual de específica que el DTC-c, pero por su mayor invasividad debería ser reservada sólo para confirmar la presencia de FOP indicada por el DTC-c 14 . A pesar de su menor complejidad la ecocardiografía transtorácica (ETT) convencional tiene una sensibilidad y una especificidad muy inferiores a las descritas para la detección del FOP con CDI, y sólo el empleo de criterios muy estrictos, que incluyan inyección de microburbujas (lo que no es realizado de forma sistemática durante el cribado de fuentes cardioembólicas) y técnicas de imagen de segundo armónico (no disponibles en los equipos más antiguos y disponibles pero no siempre utilizadas en los equipos más recientes), puede llevar a alcanzar resultados comparables con los de las otras dos pruebas 15 .…”

Section: Figura 2 Registro Masivo (Más De 10) De Hits En Las Cuatro unclassified

Algunas aplicaciones del Doppler transcraneal no habituales en las unidades de cuidados intensivos

Álvarez-Fernández

Pérez-Quintero

2009

Medicina Intensiva

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“…These characteristics make TCD testing with agitated saline at least equivalent to echocardiography for detection of right-to-left shunts such as patent foramen ovale. [17][18][19][20][21][22] Experimental data suggest that perflutren-lipid S larger than 5 are eliminated from the circulation by adhesion in capillaries, 23 whereas air S cannot be detected without a shunt (these are filtered out by lung capillaries of 8 to 12 diameter). Therefore, a theoretical overlap for the 5 to 8 range in both size groups becomes negligible ( Figure 1A).…”

Section: Methodsmentioning

confidence: 99%

Quantification of Microspheres Appearance in Brain Vessels

Sharma

Tsivgoulis²,

Lao

et al. 2008

Stroke

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Background and Purpose-Characteristics of ultrasound-activated gaseous microspheres (S) reflective of their size and quantities are needed for future dose-escalation and drug delivery trials. Methods-A double-blind, interobserver-validated analysis of multi-gate power-motion Doppler S traces included large (Ͼ8) S from agitated saline injections in the right-to-left shunt (RLS) positive stroke patients and small (Ͻ5) S from acute patients without shunts receiving thrombolysis and perflutren-lipid S. Results-In 101 S traces from 50 RLS-positive and 10 thrombolysisϩS treated patients, a large S passage had median maximum duration 30. can quantify the dose of delivered S. Ultrasound can determine a minimum number of S needed to achieve constant flow enhancement and targeted drug delivery. Propagation speed of S smaller than red blood cells may reflect plasma flow velocities around acute occlusions.

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Comparison of transthoracic echocardiography using second harmonic imaging, transcranial Doppler and transesophageal echocardiography for the detection of patent foramen ovale in stroke patients

Cited by 78 publications

References 37 publications

Prevalence of aneurysm of the interatrial septum in the general population and in patients with a recent episode of cryptogenetic ischemic stroke: a tissue harmonic imaging transthoracic ecocardiography study in 5.631 patients

Prevalence of aneurysm of the interatrial septum in the general population and in patients with a recent episode of cryptogenetic ischemic stroke: a tissue harmonic imaging transthoracic ecocardiography study in 5.631 patients

Algunas aplicaciones del Doppler transcraneal no habituales en las unidades de cuidados intensivos

Quantification of Microspheres Appearance in Brain Vessels

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