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Aortic root dilatation in PFO‐related cryptogenic stroke: A propensity score–matched analysis
Author(s) -
Beyls Christophe,
Bohbot Yohann,
Marion Bourgain,
Canaple Sandrine,
Guillaumont MariePierre,
Jarry Geneviève,
Fournier Alexandre,
Malaquin Dorothée,
AbouArab Osama,
Mahjoub Yazine,
Tribouilloy Christophe,
Leborgne Laurent
Publication year - 2020
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14711
Subject(s) - medicine , cardiology , patent foramen ovale , ascending aorta , propensity score matching , aortic root , aorta , stroke (engine) , migraine , mechanical engineering , engineering
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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