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. 2024 Jun 10;76(1):73.
doi: 10.1186/s43044-024-00504-3.

Prevalence and characteristics of patent foramen ovale in a sample of Egyptian population: a computed tomography study

Ahmed Shehata  1 , Abdulaziz Nasser  1 , Ahmed Mohsen  1 , Amir Anwar Samaan  1   2 , Amir Mostafa  1   2 , Mohamed Hassan  3   4
Affiliations

Prevalence and characteristics of patent foramen ovale in a sample of Egyptian population: a computed tomography study

Ahmed Shehata et al. Egypt Heart J. .

Abstract

Background: The reported prevalence of patent foramen ovale (PFO) in the general population is variable. It ranges between 8.6 and 42% according to the population studied and the imaging technique used. We aim to prospectively assess the prevalence and characteristics of PFO and interatrial septum (IAS) abnormalities as well as the related clinical manifestations in a sample of Egyptian population.

Results: This study comprised 1000 patients who were referred for CT coronary angiography (CTCA). Mean age was 52.5 ± 10.9 years. The prevalence of PFO among the studied population was 16.3%; closed PFO (grade I) 44.2%, open PFO (grade II) 50.9%, and open PFO with jet (grade III) 4.9%. Anatomical high-risk PFO features-defined as the presence of at least 2 or more of the following (diameter ≥ 2 mm, length ≥ 10 mm, septal aneurysm "ASA", or redundant septum)-were found in 51.5% of PFOs' population. Other IAS abnormalities as redundant septum (8.6%), ASA (5.3%), Bachmann's bundle (4.5%), microaneurysm (2.6%), and atrial septal defect (ASD) (0.4%) were detected. There was a lower rate of coexistence of ASA with PFO (p = 0.031). Syncope was significantly higher in patients with PFO compared to those without PFO (6.7% vs. 1.6%, p = 0.001). Stroke, transient ischaemic attacks (TIA), and dizziness were similar in both groups. TIA, dizziness, and syncope were significantly higher in patients with IAS abnormalities including PFO compared to those without IAS abnormalities. Syncope was also significantly higher in PFO with high-risk anatomical features compared to those with non-high-risk PFO population (p = 0.02).

Conclusion: The prevalence of PFO in our study was approximately 16.3%, almost half of them showed anatomical high-risk features for stroke. Dizziness, syncope and TIA were significantly higher in patients with IAS abnormalities including PFO.

Keywords: CT; Interatrial septum abnormalities; PFO; Prevalence; Stroke; Syncope.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Classification of PFO. (a, b) Grade I closed PFO in sagittal oblique and axial views. (c, d) Grade II open PFO in sagittal oblique and axial views. (e) Grade III open PFO with jet contrast seen in the right atrium (white arrow) in sagittal oblique view.
Fig. 2
Fig. 2
Different IAS abnormalities other than PFO. (a, b) Axial view showing ASA with septal excursion ≥ 10 mm from the midline. (c) Axial view showing IAS outpouching (microaneurysm) with septal excursion < 10 mm from the midline. (d, e) Axial view showing redundant IAS. (f, g) Axial view showing Bachmann’s bundle
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