キタガワ カズオ   KITAGAWA KAZUO
  北川 一夫
   所属   医学部 医学科(東京女子医科大学病院)
   職種   教授・基幹分野長
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Localization of Infratentorial Lesion could Predict Patent Foramen Ovale as an Etiology in Embolic Stroke of Undetermined Source.
掲載誌名 正式名:Journal of atherosclerosis and thrombosis
略  称:J Atheroscler Thromb
ISSNコード:18803873/13403478
掲載区分国外
巻・号・頁 pp.in press
著者・共著者 Ishizuka Kentaro†*, Toi Sono, Hoshino Takao, Higuchi Eiko, Kitagawa Kazuo
発行年月 2021/05
概要 AIM:Embolic stroke of undetermined source (ESUS) is a clinical construct introduced to describe cryptogenic stroke cases with ambiguous diagnoses. Cardiac causes are recognized as a major cause of ESUS, Patent foramen ovale (PFO) being among them. We aimed to investigate the relationship between infarct patterns and PFO in patients with ESUS.METHODS:We evaluated 190 consecutive patients with ESUS registered in the Tokyo Women's Medical University Stroke Registry. Among them, 94 patients who underwent magnetic resonance imaging and angiography, as well as transthoracic and transesophageal echocardiography, were included in this study. The infarct patterns were classified according to location (infratentorial or non-infratentorial lesions), size (small or large infarcts), and number (single or multiple lesions).RESULTS:Prevalence of PFO was significantly higher in patients in the infratentorial than those in the non-infratentorial lesion group (40.7% versus 14.9%, respectively; P=0.007). However, neither lesion size nor number were associated with PFO. In multivariate logistic regression analysis, the presence of infratentorial lesions was independently associated with PFO in ESUS patients (odds ratio: 2.18; 95% confidence interval: 1.24-3.95; P<0.007). In 21 patients with PFO, large PFOs were more prevalent in the infratentorial than in the non-infratentorial lesion group.CONCLUSIONS:Infratentorial lesions may be independently associated with PFO in patients with ESUS. The presence of infratentorial lesions could predict the presence of PFO in ESUS cases.
DOI 10.5551/jat.61200
PMID 33952811