Patent foramen ovale and asymptomatic brain lesions in military fighter pilots

Kang, Kyung Wook; Kim, Joon‐Tae; Choi, Won‐Ho; Park, Won-Ju; Shin, Y. H.; Choi, Kang‐Ho

doi:10.1016/j.clineuro.2014.07.011

Cited by 4 publications

(7 citation statements)

References 44 publications

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“…TCD has been used in clinical settings to investigate the potential for paradoxical cerebral embolism in postembolic stroke patients . Additionally, previous studies have used TCD to investigate the association between the presence of a PFO and the incidence of brain lesions in divers with a history of decompression sickness and military fighter pilots who perform numerous anti‐gravity straining maneuvers . Using TCD, it is also possible to quantify the number of microbubbles that appear in the cerebral circulation …”

Section: Methods For Detecting and Quantifying Blood Flow Through Ipavamentioning

confidence: 99%

“…25 Additionally, previous studies have used TCD to investigate the association between the presence of a PFO and the incidence of brain lesions in divers with a history of decompression sickness 26 and military fighter pilots who perform numerous anti-gravity straining maneuvers. 27 Using TCD, it is also possible to quantify the number of microbubbles that appear in the cerebral circulation. 28 TESCE is often regarded as the gold standard method to detect a PFO, although several studies have reported TTSCE as performing equally effectively.…”

Section: Saline Contrast Echocardiographymentioning

confidence: 99%

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Clinical Consideration for Techniques to Detect and Quantify Blood Flow through Intrapulmonary Arteriovenous Anastomoses: Lessons from Physiological Studies

2015

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Intrapulmonary arteriovenous anastomoses (IPAVA) are large diameter (>50 μm) vascular conduits, present in >95% of healthy humans. Because IPAVA are large diameter pathways that allow blood flow to bypass the pulmonary capillary network, blood flow through IPAVA (QIPAVA) can permit the transpulmonary passage of particles larger than pulmonary capillaries. IPAVA have been known to exist for over 50 years, but their physiological and clinical significance are still being established; although, currently suggested roles for QIPAVA include allowing emboli to reach the systemic circulation and providing a source of shunt. Studying QIPAVA is an important area of research and as the suggested roles become better established, detecting and quantifying QIPAVA may become significantly more important in the clinic. Several techniques that can be used to quantify and/or detect QIPAVA in animals, ex vivo human/animal lungs, and intact healthy humans; microspheres, radiolabeled macroaggregated albumin particles, and saline contrast echocardiography, are reviewed with limitations and advantages to each. The current body of literature using these techniques to study QIPAVA in animals, ex vivo lungs, and healthy humans has established conditions when QIPAVA is present, such as during exercise or with arterial hypoxemia and conditions when QIPAVA is absent, such as at rest or during exercise breathing 100% O2 . Many of these physiological studies have direct application to patient populations and we discuss each of these findings in the context of their potential to influence the clinical utility, and interpretation, of the results from these techniques highlighted in this review.

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Section: Methods For Detecting and Quantifying Blood Flow Through Ipavamentioning

confidence: 99%

Section: Saline Contrast Echocardiographymentioning

confidence: 99%

Clinical Consideration for Techniques to Detect and Quantify Blood Flow through Intrapulmonary Arteriovenous Anastomoses: Lessons from Physiological Studies

2015

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“…A few prospective reports have also revealed a statistically significant association between PFO and white-matter lesions on MRI in military aircraft pilots [140] and in divers [9], but this was not confirmed by another report [141]. Moreover, arterial gas bubbles have been observed more frequently in divers with PFO than in those without PFO [142,143].…”

Section: Is Pfo Associated With Decompression Sickness? Which Are the Underlying Mechanisms?mentioning

confidence: 96%

European position paper on the management of patients with patent foramen ovale. Part II - Decompression sickness, migraine, arterial deoxygenation syndromes and select high-risk clinical conditions

Pristipino¹,

Germonpré²,

Toni³

et al. 2021

EuroIntervention

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“…Exposures included carbon monoxide (29 studies, n = 1,409; 28 studies/n = 1,373 in meta-analysis), carbon disulfide ( 4studies, n = 797; 3 studies/n = 131 in meta-analysis), [44][45][46][47] 1,2dichloroethane (4 studies, n = 40, n = 40 in meta-analysis), [48][49][50][51] toluene (4 studies, n = 64/n = 64 in meta-analysis), [52][53][54][55] diving ( 4studies, n = 266; 4 studies/n = 172 in meta-analysis), [56][57][58][59] high altitude (11 studies, n = 950; 5 studies/n = 164 in meta-analysis), [60][61][62][63][64][65][66][67][68][69][70] contact sports (3 studies, n = 629; not meta-analyzable), [71][72][73]…”

Section: Characteristics Of Included Studies and Populationsmentioning

confidence: 99%

Occupational and domestic exposure associations with cerebral small vessel disease and vascular dementia: A systematic review and meta‐analysis

Clancy,

Cheng,

Brara

et al. 2024

Alzheimer's & Dementia

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INTRODUCTIONThe prevalence of cerebral smallvessel disease (SVD) and vascular dementia according to workplace or domestic exposure to hazardous substances is unclear.METHODSWe included studies assessing occupational and domestic hazards/at‐risk occupations and SVD features. We pooled prevalence estimates using random‐effects models where possible, or presented a narrative synthesis.RESULTSWe included 85 studies (n = 47,743, mean age = 44·5 years). 52/85 reported poolable estimates. SVD prevalence in populations exposed to carbon monoxide was 81%(95% CI = 60‐93%; n = 1373; results unchanged in meta‐regression), carbon disulfide73% (95% CI = 54‐87%; n = 131), 1,2‐dichloroethane 88% (95% CI = 4‐100%, n = 40), toluene 82% (95% CI = 3‐100%, n = 64), high altitude 49% (95% CI = 38‐60%; n = 164),and diving 24% (95% CI = 5‐67%, n = 172). We narratively reviewed vascular dementia studies and contact sport, lead, military, pesticide, and solvent exposures as estimates were too few/varied to pool.DISCUSSIONSVD and vascular dementia may be associated with occupational/domestic exposure to hazardous substances. CRD42021297800.

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Patent foramen ovale and asymptomatic brain lesions in military fighter pilots

Cited by 4 publications

References 44 publications

Clinical Consideration for Techniques to Detect and Quantify Blood Flow through Intrapulmonary Arteriovenous Anastomoses: Lessons from Physiological Studies

Clinical Consideration for Techniques to Detect and Quantify Blood Flow through Intrapulmonary Arteriovenous Anastomoses: Lessons from Physiological Studies

European position paper on the management of patients with patent foramen ovale. Part II - Decompression sickness, migraine, arterial deoxygenation syndromes and select high-risk clinical conditions

Occupational and domestic exposure associations with cerebral small vessel disease and vascular dementia: A systematic review and meta‐analysis

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