Endocardial Device Leads in Patients with Patent Foramen Ovale: Echocardiographic Correlates of Stroke/TIA and Mortality.
Background Echocardiographically detected patent foramen ovale (PFO) has been associated with stroke/transient ischemic attack (TIA) in patients with cardiac implantable electronic devices (CIEDs). We sought to evaluate the relationship between echocardiographic characteristics and risk of stroke/TI...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 40; no. 3; pp. 310 - 323 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Mar2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=121807369&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 121807369 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Mar2017 vid: 40 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 121807369 121807369 121807369 10.1111/pace.12985 121807369 ppf: 310 ppct: 13 formats: fmt: @attributes: type: P tig: atl: Endocardial Device Leads in Patients with Patent Foramen Ovale: Echocardiographic Correlates of Stroke/TIA and Mortality. aug: au: PONAMGI, SHIVA P. VAIDYA, VAIBHAV R. DESIMONE, CHRISTOPHER V. NOHERIA, AMIT HODGE, DAVID O. SLUSSER, JOSHUA P. AMMASH, NASER M. BRUCE, CHARLES J. RABINSTEIN, ALEJANDRO A. FRIEDMAN, PAUL A. ASIRVATHAM, SAMUEL J. affil: Division of Hospital Internal Medicine, Mayo Clinic Health System, Austin Minnesota sug: subj: Cerebral Ischemia, Transient Risk Factors Heart Septal Defects, Atrial Ultrasonography Stroke Risk Factors Pacemaker, Artificial Defibrillators, Implantable Cox Proportional Hazards Model Human Retrospective Design Mortality Multivariate Analysis Univariate Statistics Equipment Safety Minnesota Echocardiography, Transesophageal Descriptive Statistics McNemar's Test Kaplan-Meier Estimator Log-Rank Test Data Analysis Software Confidence Intervals Female Male Middle Age Aged Middle Aged: 45-64 years Aged: 65+ years Female Male ab: Background Echocardiographically detected patent foramen ovale (PFO) has been associated with stroke/transient ischemic attack (TIA) in patients with cardiac implantable electronic devices (CIEDs). We sought to evaluate the relationship between echocardiographic characteristics and risk of stroke/TIA and mortality in CIED patients with PFO. Methods In 6,086 device patients, PFO was detected in 319 patients. A baseline echocardiogram was present in 250 patients, with 186 having a follow-up echocardiogram. Results Of 250 patients with a baseline echocardiogram, 9.6% (n = 24) had a stroke/TIA during mean follow-up of 5.3 ± 3.1 years; and 42% (n = 105) died over 7.1 ± 3.7 years. Atrial septal aneurysm, prominent Eustachian valve, visible shunting across PFO, baseline or change in estimated right ventricular systolic pressure (RVSP)/tricuspid regurgitation (TR), or maximum RVSP were not associated with postimplant stroke/TIA (P > 0.05). An exploratory multivariate analysis using time-dependent Cox models showed increased hazard of death in patients with increase in TR ≥2 grades (hazard ratio [HR] 1.780, 95% confidence interval [CI] 1.447-2.189, P < 0.0001), or increase in RVSP by >10 mm Hg (HR 2.018, 95% CI 1.593-2.556, P < 0.0001), or maximum RVSP in follow-up (HR 1.432, 95% CI 1.351-1.516, P < 0.0001). A significant increase (P < 0.001) in TR was also noted during follow-up. Conclusions In patients with CIED and PFO, structural and hemodynamic echocardiographic markers did not predict future stroke/TIA. However, a significantly higher TR or RVSP was associated with higher mortality. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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