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Article Dans Une Revue Echocardiography Année : 2020

Aortic root dilatation in PFO-related cryptogenic stroke: A propensity score-matched analysis

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Résumé

Background Dilatation of the ascending aorta has an important role in the anatomical conformation of interatrial septum (IAS) especially when a patent foramen ovale (PFO) is present. The aim of the study was to investigate the relationship between ascending aortic dilation and PFO-related cryptogenic stroke in a cohort of cryptogenic strokes. Methods It is a retrospective, single-center echocardiographic study assessing aortic root dilatation in 315 consecutive patients with cryptogenic stroke between January 2011 and January 2019. Aortic root dilatation was defined by a diameter of the Valsalva sinuses of the proximal aorta >40 mm. Predictive factors of PFO were assessed by a multivariate analysis. Propensity score matching was applied to account for clinical differences. Results Of the 315 patients, 68 (22%) had an aortic root dilatation and 167 (53%) had a PFO. In the aortic root dilation group, PFO was more often diagnosed (n = 47/68 [69%], vs n = 120/247 [49%], P = .004). In the PFO group with aortic dilatation, IAS was more mobile (n = 37/47[79%] vs n = 69/120[57%], P < .012) and smaller (2.3 +/- 0.5 vs 2.5 +/- 0.5 mm, P < .009). On multivariate analysis, aortic root dilatation (OR: 2.6; 95% CI [1.2-5.6]; P = .001) and IAS hypermobility (OR: 5.2 95% CI [2.7-10]; P = .001) were associated with PFO. After propensity matching, aortic root dilatation remained strongly associated with PFO (n = 34/107 [32%] vs 15/107[14%], P = .002). Conclusion Aortic root dilation and IAS hypermobility were strongly associated with PFO-related cryptogenic stroke.
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Dates et versions

hal-03575223 , version 1 (15-02-2022)

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Marie-Pierre Guillaumont, Genevieve Jarry, Alexandre Fournier, Dorothee Malaquin, Osama Abou-Arab, et al.. Aortic root dilatation in PFO-related cryptogenic stroke: A propensity score-matched analysis. Echocardiography, 2020, 37 (6), pp.883-890. ⟨10.1111/echo.14711⟩. ⟨hal-03575223⟩
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