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. 2020 Jun;37(6):883-890.
doi: 10.1111/echo.14711. Epub 2020 May 25.

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

Christophe Beyls  1 , Yohann Bohbot  2 , Bourgain Marion  2 , Sandrine Canaple  3 , Marie-Pierre Guillaumont  2 , Geneviève Jarry  4 , Alexandre Fournier  4 , Dorothée Malaquin  4 , Osama Abou-Arab  1 , Yazine Mahjoub  1 , Christophe Tribouilloy  2 , Laurent Leborgne  4
Affiliations

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

Christophe Beyls et al. Echocardiography. 2020 Jun.

Abstract

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.

Keywords: aortic root dilatation; cryptogenic stroke; echocardiography; patent foramen ovale; patent foramen ovale closure.

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References

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