Atrial Septal Abnormalities and Cryptogenic Stroke: A Cross-Sectional
Study

Marzieh      Aliramezany; Mansoor      Moazenzadeh; Amin      Sayyadi; Khadijeh      Mohammadi; Hamidreza      Barzegar; Maryam      Aliramezany

doi:10.2174/011871529X294809240415070950

Abstract

Background: Cryptogenic stroke, whose underlying pathology is unknown, accounts for 30-40% of all ischemic strokes. Studies have mentioned the association between atrial septal abnormalities and cryptogenic stroke, but there are still disparities in the results among different studies.

Objective: We aimed to clarify the prevalence of atrial septal abnormalities in patients with cryptogenic stroke.

Methods: We conducted a cross-sectional study on 91 patients with cryptogenic stroke/transient ischemic attack from March 2021 to March 2022. We evaluated the demographic data of the patients and also the existence of neurologic attacks. Furthermore, echocardiography was performed to determine the type of atrial septal abnormality.

Results: Out of 91 patients with cryptogenic stroke/transient ischemic attack, 16 patients (17.5%) had patent foramen ovale, 1 man (1.1%) had atrial septal aneurysm, and 1 woman (1.1%) had an atrial septal defect. Patients with patent foramen ovale were significantly younger than those without. The size of patent foramen ovale in patients with cryptogenic stroke was larger than those with transient ischemic attack, but this difference was not significant. Also, the size of the patent foramen ovale (length and width) was not significantly related to any of the demographic variables (p-value = 0.544, 0.604).

Conclusion: Based on our results, the prevalence of atrial septal abnormalities was relatively high. Considering these issues and the importance of preventing neurological accidents in patients, especially young people, it is recommended to always consider atrial septal disorders and, if diagnosed, to carry out the necessary treatment in this field.

« Previous Next »

Graphical Abstract

[1]
Leonard, Y; Marras, M; Calcaterra, G; Bassareo, PP Association between atrial septal abnormalities (patent foramen ovale, atrial septal defect, interatrial septal aneurysm) and cryptogenic stroke in children. J. Ped. Neonat. Individ. Med.,  2021, 10(1), e100154.

[2]
Saini, V.; Guada, L.; Yavagal, D.R. Global epidemiology of stroke and access to acute ischemic stroke interventions. Neurology,  2021, 97(20_Supplement_2), S6-S16.
 [http://dx.doi.org/10.1212/WNL.0000000000012781] [PMID: 34785599]

[3]
Feigin, V.L.; Brainin, M.; Norrving, B.; Martins, S.; Sacco, R.L.; Hacke, W.; Fisher, M.; Pandian, J.; Lindsay, P. World stroke organization (WSO): Global stroke fact sheet 2022. Int. J. Stroke,  2022, 17(1), 18-29.
 [http://dx.doi.org/10.1177/17474930211065917] [PMID: 34986727]

[4]
Feigin, V.L.; Stark, B.A.; Johnson, C.O.; Roth, G.A.; Bisignano, C.; Abady, G.G.; Abbasifard, M.; Abbasi-Kangevari, M.; Abd-Allah, F.; Abedi, V.; Abualhasan, A.; Abu-Rmeileh, N.M.E.; Abushouk, A.I.; Adebayo, O.M.; Agarwal, G.; Agasthi, P.; Ahinkorah, B.O.; Ahmad, S.; Ahmadi, S.; Ahmed Salih, Y.; Aji, B.; Akbarpour, S.; Akinyemi, R.O.; Al Hamad, H.; Alahdab, F.; Alif, S.M.; Alipour, V.; Aljunid, S.M.; Almustanyir, S.; Al-Raddadi, R.M.; Al-Shahi Salman, R.; Alvis-Guzman, N.; Ancuceanu, R.; Anderlini, D.; Anderson, J.A.; Ansar, A.; Antonazzo, I.C.; Arabloo, J.; Ärnlöv, J.; Artanti, K.D.; Aryan, Z.; Asgari, S.; Ashraf, T.; Athar, M.; Atreya, A.; Ausloos, M.; Baig, A.A.; Baltatu, O.C.; Banach, M.; Barboza, M.A.; Barker-Collo, S.L.; Bärnighausen, T.W.; Barone, M.T.U.; Basu, S.; Bazmandegan, G.; Beghi, E.; Beheshti, M.; Béjot, Y.; Bell, A.W.; Bennett, D.A.; Bensenor, I.M.; Bezabhe, W.M.; Bezabih, Y.M.; Bhagavathula, A.S.; Bhardwaj, P.; Bhattacharyya, K.; Bijani, A.; Bikbov, B.; Birhanu, M.M.; Boloor, A.; Bonny, A.; Brauer, M.; Brenner, H.; Bryazka, D.; Butt, Z.A.; Caetano dos Santos, F.L.; Campos-Nonato, I.R.; Cantu-Brito, C.; Carrero, J.J.; Castañeda-Orjuela, C.A.; Catapano, A.L.; Chakraborty, P.A.; Charan, J.; Choudhari, S.G.; Chowdhury, E.K.; Chu, D-T.; Chung, S-C.; Colozza, D.; Costa, V.M.; Costanzo, S.; Criqui, M.H.; Dadras, O.; Dagnew, B.; Dai, X.; Dalal, K.; Damasceno, A.A.M.; D’Amico, E.; Dandona, L.; Dandona, R.; Darega Gela, J.; Davletov, K.; De la Cruz-Góngora, V.; Desai, R.; Dhamnetiya, D.; Dharmaratne, S.D.; Dhimal, M.L.; Dhimal, M.; Diaz, D.; Dichgans, M.; Dokova, K.; Doshi, R.; Douiri, A.; Duncan, B.B.; Eftekharzadeh, S.; Ekholuenetale, M.; El Nahas, N.; Elgendy, I.Y.; Elhadi, M.; El-Jaafary, S.I.; Endres, M.; Endries, A.Y.; Erku, D.A.; Faraon, E.J.A.; Farooque, U.; Farzadfar, F.; Feroze, A.H.; Filip, I.; Fischer, F.; Flood, D.; Gad, M.M.; Gaidhane, S.; Ghanei Gheshlagh, R.; Ghashghaee, A.; Ghith, N.; Ghozali, G.; Ghozy, S.; Gialluisi, A.; Giampaoli, S.; Gilani, S.A.; Gill, P.S.; Gnedovskaya, E.V.; Golechha, M.; Goulart, A.C.; Guo, Y.; Gupta, R.; Gupta, V.B.; Gupta, V.K.; Gyanwali, P.; Hafezi-Nejad, N.; Hamidi, S.; Hanif, A.; Hankey, G.J.; Hargono, A.; Hashi, A.; Hassan, T.S.; Hassen, H.Y.; Havmoeller, R.J.; Hay, S.I.; Hayat, K.; Hegazy, M.I.; Herteliu, C.; Holla, R.; Hostiuc, S.; Househ, M.; Huang, J.; Humayun, A.; Hwang, B-F.; Iacoviello, L.; Iavicoli, I.; Ibitoye, S.E.; Ilesanmi, O.S.; Ilic, I.M.; Ilic, M.D.; Iqbal, U.; Irvani, S.S.N.; Islam, S.M.S.; Ismail, N.E.; Iso, H.; Isola, G.; Iwagami, M.; Jacob, L.; Jain, V.; Jang, S-I.; Jayapal, S.K.; Jayaram, S.; Jayawardena, R.; Jeemon, P.; Jha, R.P.; Johnson, W.D.; Jonas, J.B.; Joseph, N.; Jozwiak, J.J.; Jürisson, M.; Kalani, R.; Kalhor, R.; Kalkonde, Y.; Kamath, A.; Kamiab, Z.; Kanchan, T.; Kandel, H.; Karch, A.; Katoto, P.D.M.C.; Kayode, G.A.; Keshavarz, P.; Khader, Y.S.; Khan, E.A.; Khan, I.A.; Khan, M.; Khan, M.A.B.; Khatib, M.N.; Khubchandani, J.; Kim, G.R.; Kim, M.S.; Kim, Y.J.; Kisa, A.; Kisa, S.; Kivimäki, M.; Kolte, D.; Koolivand, A.; Koulmane Laxminarayana, S.L.; Koyanagi, A.; Krishan, K.; Krishnamoorthy, V.; Krishnamurthi, R.V.; Kumar, G.A.; Kusuma, D.; La Vecchia, C.; Lacey, B.; Lak, H.M.; Lallukka, T.; Lasrado, S.; Lavados, P.M.; Leonardi, M.; Li, B.; Li, S.; Lin, H.; Lin, R-T.; Liu, X.; Lo, W.D.; Lorkowski, S.; Lucchetti, G.; Lutzky Saute, R.; Magdy Abd El Razek, H.; Magnani, F.G.; Mahajan, P.B.; Majeed, A.; Makki, A.; Malekzadeh, R.; Malik, A.A.; Manafi, N.; Mansournia, M.A.; Mantovani, L.G.; Martini, S.; Mazzaglia, G.; Mehndiratta, M.M.; Menezes, R.G.; Meretoja, A.; Mersha, A.G.; Miao Jonasson, J.; Miazgowski, B.; Miazgowski, T.; Michalek, I.M.; Mirrakhimov, E.M.; Mohammad, Y.; Mohammadian-Hafshejani, A.; Mohammed, S.; Mokdad, A.H.; Mokhayeri, Y.; Molokhia, M.; Moni, M.A.; Montasir, A.A.; Moradzadeh, R.; Morawska, L.; Morze, J.; Muruet, W.; Musa, K.I.; Nagarajan, A.J.; Naghavi, M.; Narasimha Swamy, S.; Nascimento, B.R.; Negoi, R.I.; Neupane Kandel, S.; Nguyen, T.H.; Norrving, B.; Noubiap, J.J.; Nwatah, V.E.; Oancea, B.; Odukoya, O.O.; Olagunju, A.T.; Orru, H.; Owolabi, M.O.; Padubidri, J.R.; Pana, A.; Parekh, T.; Park, E-C.; Pashazadeh Kan, F.; Pathak, M.; Peres, M.F.P.; Perianayagam, A.; Pham, T-M.; Piradov, M.A.; Podder, V.; Polinder, S.; Postma, M.J.; Pourshams, A.; Radfar, A.; Rafiei, A.; Raggi, A.; Rahim, F.; Rahimi-Movaghar, V.; Rahman, M.; Rahman, M.A.; Rahmani, A.M.; Rajai, N.; Ranasinghe, P.; Rao, C.R.; Rao, S.J.; Rathi, P.; Rawaf, D.L.; Rawaf, S.; Reitsma, M.B.; Renjith, V.; Renzaho, A.M.N.; Rezapour, A.; Rodriguez, J.A.B.; Roever, L.; Romoli, M.; Rynkiewicz, A.; Sacco, S.; Sadeghi, M.; Saeedi Moghaddam, S.; Sahebkar, A.; Saif-Ur-Rahman, K.M.; Salah, R.; Samaei, M.; Samy, A.M.; Santos, I.S.; Santric-Milicevic, M.M.; Sarrafzadegan, N.; Sathian, B.; Sattin, D.; Schiavolin, S.; Schlaich, M.P.; Schmidt, M.I.; Schutte, A.E.; Sepanlou, S.G.; Seylani, A.; Sha, F.; Shahabi, S.; Shaikh, M.A.; Shannawaz, M.; Shawon, M.S.R.; Sheikh, A.; Sheikhbahaei, S.; Shibuya, K.; Siabani, S.; Silva, D.A.S.; Singh, J.A.; Singh, J.K.; Skryabin, V.Y.; Skryabina, A.A.; Sobaih, B.H.; Stortecky, S.; Stranges, S.; Tadesse, E.G.; Tarigan, I.U.; Temsah, M-H.; Teuschl, Y.; Thrift, A.G.; Tonelli, M.; Tovani-Palone, M.R.; Tran, B.X.; Tripathi, M.; Tsegaye, G.W.; Ullah, A.; Unim, B.; Unnikrishnan, B.; Vakilian, A.; Valadan Tahbaz, S.; Vasankari, T.J.; Venketasubramanian, N.; Vervoort, D.; Vo, B.; Volovici, V.; Vosoughi, K.; Vu, G.T.; Vu, L.G.; Wafa, H.A.; Waheed, Y.; Wang, Y.; Wijeratne, T.; Winkler, A.S.; Wolfe, C.D.A.; Woodward, M.; Wu, J.H.; Wulf Hanson, S.; Xu, X.; Yadav, L.; Yadollahpour, A.; Yahyazadeh Jabbari, S.H.; Yamagishi, K.; Yatsuya, H.; Yonemoto, N.; Yu, C.; Yunusa, I.; Zaman, M.S.; Zaman, S.B.; Zamanian, M.; Zand, R.; Zandifar, A.; Zastrozhin, M.S.; Zastrozhina, A.; Zhang, Y.; Zhang, Z-J.; Zhong, C.; Zuniga, Y.M.H.; Murray, C.J.L. Global, regional, and national burden of stroke and its risk factors, 1990–2019: A systematic analysis for the global burden of disease study 2019. Lancet Neurol.,  2021, 20(10), 795-820.
 [http://dx.doi.org/10.1016/S1474-4422(21)00252-0] [PMID: 34487721]

[5]
Béjot, Y.; Bailly, H.; Durier, J.; Giroud, M. Epidemiology of stroke in Europe and trends for the 21st century. Presse Med.,  2016, 45(12), e391-e398.
 [http://dx.doi.org/10.1016/j.lpm.2016.10.003] [PMID: 27816343]

[6]
George, M.G. Risk factors for ischemic stroke in younger adults: A focused update. Stroke,  2020, 51(3), 729-735.
 [http://dx.doi.org/10.1161/STROKEAHA.119.024156] [PMID: 32078487]

[7]
George, M.G.; Tong, X.; Bowman, B.A. Prevalence of cardiovascular risk factors and strokes in younger adults. JAMA Neurol.,  2017, 74(6), 695-703.
 [http://dx.doi.org/10.1001/jamaneurol.2017.0020] [PMID: 28395017]

[8]
Kivioja, R.; Pietilä, A.; Martinez-Majander, N.; Gordin, D.; Havulinna, A.S.; Salomaa, V.; Aarnio, K.; Curtze, S.; Leiviskä, J.; Rodríguez-Pardo, J.; Surakka, I.; Kaste, M.; Tatlisumak, T.; Putaala, J. Risk factors for early-onset ischemic stroke: A case-control study. J. Am. Heart Assoc.,  2018, 7(21), e009774.
 [http://dx.doi.org/10.1161/JAHA.118.009774] [PMID: 30608196]

[9]
Handke, M.; Harloff, A.; Olschewski, M.; Hetzel, A.; Geibel, A. Patent foramen ovale and cryptogenic stroke in older patients. N. Engl. J. Med.,  2007, 357(22), 2262-2268.
 [http://dx.doi.org/10.1056/NEJMoa071422] [PMID: 18046029]

[10]
West, B.H.; Noureddin, N.; Mamzhi, Y.; Low, C.G.; Coluzzi, A.C.; Shih, E.J.; Gevorgyan Fleming, R.; Saver, J.L.; Liebeskind, D.S.; Charles, A.; Tobis, J.M. Frequency of patent foramen ovale and migraine in patients with cryptogenic stroke. Stroke,  2018, 49(5), 1123-1128.
 [http://dx.doi.org/10.1161/STROKEAHA.117.020160] [PMID: 29636424]

[11]
Kuriki, A.; Ueno, Y.; Kamiya, Y.; Shimizu, T.; Doijiri, R.; Tateishi, Y.; Kikuno, M.; Shimada, Y.; Takekawa, H.; Yamaguchi, E.; Koga, M.; Ihara, M.; Ono, K.; Tsujino, A.; Hirata, K.; Toyoda, K.; Hasegawa, Y.; Hattori, N.; Urabe, T. Atrial septal aneurysm may cause in-hospital recurrence of cryptogenic stroke. J. Atheroscler. Thromb.,  2021, 28(5), 514-523.
 [http://dx.doi.org/10.5551/jat.56440] [PMID: 32684557]

[12]
Palmieri, V.; Tufano, A.; Carmen Bonito, M.; Martino, S.; Sabatella, M.; Di Minno, G.; Celentano, A. Right-to-left shunt, atrial septal aneurysm and thrombophilia in patients with cryptogenic stroke or TIA vs. those with venous thrombo-embolism. Int. J. Cardiol.,  2008, 130(1), 99-102.
 [http://dx.doi.org/10.1016/j.ijcard.2007.06.072] [PMID: 17643530]

[13]
Indolfi, G.; Bartolini, E.; Trapani, S.; Azzari, C.; Resti, M. Cryptogenic stroke in a boy with atrial septal defect and hyperhomocysteinemia. J. Child Neurol.,  2008, 23(9), 1070-1071.
 [http://dx.doi.org/10.1177/0883073808315416] [PMID: 18474934]

[14]
Khajali, Z.; Maleki, M.; Amin, A.; Saedi, S.; Arabian, M.; Moosazadeh, M. Prevalence of cardiac dysfunction among adult patients With congenital heart disease: A single-center investigation. Indian Heart J.,  2019, 20(3), 12-19.

[15]
Kamel, H. The evolving concept of cryptogenic stroke. Continuum,  2020, 26(2), 353-362.
 [http://dx.doi.org/10.1212/CON.0000000000000832] [PMID: 32224756]

[16]
Yaghi, S.; Bernstein, R.A.; Passman, R.; Okin, P.M.; Furie, K.L. Cryptogenic stroke. Circ. Res.,  2017, 120(3), 527-540.
 [http://dx.doi.org/10.1161/CIRCRESAHA.116.308447] [PMID: 28154102]

[17]
Overell, J.R.; Bone, I.; Lees, K.R. Interatrial septal abnormalities and stroke. Neurology,  2000, 55(8), 1172-1179.
 [http://dx.doi.org/10.1212/WNL.55.8.1172] [PMID: 11071496]

[18]
Rigatelli, G.; Zuin, M.; Bilato, C. Atrial septal aneurysm contribution to the risk of cryptogenic stroke in patients with patent foramen ovale: A brief updated systematic review and meta-analysis. Trends Cardiovasc. Med.,  2022, 33(6), 329-333.
 [PMID: 35181471]

[19]
Ghosh, S.; Ghosh, A.K.; Ghosh, S.K. Patent foramen ovale and atrial septal aneurysm in cryptogenic stroke. Postgrad. Med. J.,  2007, 83(977), 173-177.
 [http://dx.doi.org/10.1136/pgmj.2006.051094] [PMID: 17344571]

[20]
Bannan, A.; Shen, R.; Silvestry, F.E.; Herrmann, H.C. Characteristics of adult patients with atrial septal defects presenting with paradoxical embolism. Catheter. Cardiovasc. Interv.,  2009, 74(7), 1066-1069.
 [http://dx.doi.org/10.1002/ccd.22170] [PMID: 19670302]

[21]
Hart, R.G.; Diener, H.C.; Coutts, S.B.; Easton, J.D.; Granger, C.B.; O’Donnell, M.J.; Sacco, R.L.; Connolly, S.J. Embolic strokes of undetermined source: The case for a new clinical construct. Lancet Neurol.,  2014, 13(4), 429-438.
 [http://dx.doi.org/10.1016/S1474-4422(13)70310-7] [PMID: 24646875]

[22]
GOICOECHEA CALVO, A. Foramen oval permeable y su relación actual con los accidentes cerebro vasculares; University of Zaragoza, 2015. 

[23]
Otto, C. Textbook of Clinical Echocardiography; Elsevier, 2018. 

[24]
Mügge, A.; Daniel, W.G.; Angermann, C.; Spes, C.; Khandheria, B.K.; Kronzon, I.; Freedberg, R.S.; Keren, A.; Dennig, K.; Engberding, R.; Sutherland, G.R.; Vered, Z.; Erbel, R.; Visser, C.A.; Lindert, O.; Hausmann, D.; Wenzlaff, P. Atrial septal aneurysm in adult patients. A multicenter study using transthoracic and transesophageal echocardiography. Circulation,  1995, 91(11), 2785-2792.
 [http://dx.doi.org/10.1161/01.CIR.91.11.2785] [PMID: 7758185]

[25]
Falk, R.H. PFO or UFO? The role of a patent foramen ovale in cryptogenic stroke. Am. Heart J.,  1991, 121(4), 1264-1266.
 [http://dx.doi.org/10.1016/0002-8703(91)90695-E] [PMID: 2008854]

[26]
Cohnheim, J. Thrombose und embolie. Vorlesungen uber allgemeine pathologie; Hirschwald, 1877, pp. 1-13.

[27]
Di Tullio, M.; Sacco, R.L.; Gopal, A.; Mohr, J.P.; Homma, S. Patent foramen ovale as a risk factor for cryptogenic stroke. Ann. Intern. Med.,  1992, 117(6), 461-465.
 [http://dx.doi.org/10.7326/0003-4819-117-6-461] [PMID: 1503349]

[28]
Benvenuti, F.; Meucci, F.; Vuolo, L.; Nistri, R.; Pracucci, G.; Picchioni, A.; Venturini, G.; Stolcova, M.; Failli, Y.; Nencini, P.; Di Mario, C.; Sarti, C. Relation between the size of patent foramen ovale and the volume of acute cerebral ischemic lesion in young patients with cryptogenic ischemic stroke. Neurol. Sci.,  2022, 43(1), 453-458.
 [http://dx.doi.org/10.1007/s10072-021-05330-y] [PMID: 34050831]

[29]
Akhondi, A.; Gevorgyan, R.; Tseng, C.H.; Slavin, L.; Dao, C.; Liebeskind, D.S.; Tobis, J.M. The association of patent foramen ovale morphology and stroke size in patients with paradoxical embolism. Circ. Cardiovasc. Interv.,  2010, 3(5), 506-510.
 [http://dx.doi.org/10.1161/CIRCINTERVENTIONS.109.908533] [PMID: 20858864]

[30]
Sadrameli, S.S.; Gadhia, R.R.; Kabir, R.; Volpi, J.J. Patent foramen ovale in cryptogenic stroke and migraine with aura: does size matter? Cureus,  2018, 10(8), e3213.
 [http://dx.doi.org/10.7759/cureus.3213] [PMID: 30405989]

[31]
Force, M.; Massabuau, P.; Larrue, V. Prevalence of atrial septal abnormalities in older patients with cryptogenic ischemic stroke or transient ischemic attack. Clin. Neurol. Neurosurg.,  2008, 110(8), 779-783.
 [http://dx.doi.org/10.1016/j.clineuro.2008.04.012] [PMID: 18534743]

[32]
Fazlinezhad, A.; Azimi, S.; Azarpazhooh, M.; Khajedaluee, M.; Kashani, M.M. Patent foramen ovale in young adults with cryptogenic stroke or transient ischemic attack. J. Tehran Univ. Heart Cent.,  2009, 4(3), 185-188.

[33]
Ali Ebrahimi, H.; Hamzeaie Moghadam, A.; Aredestani, E. Evaluation of patent foramen ovale in young adults with cryptogenic stroke. ARYA Atheroscler.,  2011, 7(2), 74-77.
 [PMID: 22577450]

[34]
Choi, J.; Kang, M.K.; Jun, J.S.; Shin, D.G.; Han, D.; Choi, S.; Cho, J.R.; Lee, N. Characteristics and prognosis of patients with cryptogenic stroke and suggestive of patent foramen ovale. Cardiovasc. Ultrasound,  2021, 19(1), 20.
 [http://dx.doi.org/10.1186/s12947-021-00255-0] [PMID: 34090472]

[35]
Koutroulou, I.; Tsivgoulis, G.; Karacostas, D.; Ikonomidis, I.; Grigoriadis, N.; Karapanayiotides, T. Prevalence of patent foramen ovale in the Greek population is high and impacts on the interpretation of the risk of paradoxical embolism (RoPE) score. Ther. Adv. Neurol. Disord.,  2020, 13, 1756286420964673.
 [http://dx.doi.org/10.1177/1756286420964673] [PMID: 33425013]

[36]
Gupta, V.; Yesilbursa, D.; Huang, W.Y.; Aggarwal, K.; Gupta, V.; Gomez, C.; Patel, V.; Miller, A.P.; Nanda, N.C. Patent foramen ovale in a large population of ischemic stroke patients: diagnosis, age distribution, gender, and race. Echocardiography,  2008, 25(2), 217-227.
 [http://dx.doi.org/10.1111/j.1540-8175.2007.00583.x] [PMID: 18269568]

[37]
Thaler, D.E.; Saver, J.L. Cryptogenic stroke and patent foramen ovale. Curr. Opin. Cardiol.,  2008, 23(6), 537-544.
 [http://dx.doi.org/10.1097/HCO.0b013e32831311bd] [PMID: 18830067]

[38]
Nakayama, R.; Takaya, Y.; Akagi, T.; Watanabe, N.; Ikeda, M.; Nakagawa, K.; Toh, N.; Ito, H. Identification of high-risk patent foramen ovale associated with cryptogenic stroke: Development of a scoring system. J. Am. Soc. Echocardiogr.,  2019, 32(7), 811-816.
 [http://dx.doi.org/10.1016/j.echo.2019.03.021] [PMID: 31130417]

[39]
Jung, J.M.; Lee, J.Y.; Kim, H.J.; Do, Y.; Kwon, S.U.; Kim, J.S.; Song, J.K.; Kang, D.W. Patent foramen ovale and infarct volume in cryptogenic stroke. J. Stroke Cerebrovasc. Dis.,  2013, 22(8), 1399-1404.
 [http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2013.04.034] [PMID: 23747019]

[40]
Mas, J.L.; Arquizan, C.; Lamy, C.; Zuber, M.; Cabanes, L.; Derumeaux, G.; Coste, J. Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both. N. Engl. J. Med.,  2001, 345(24), 1740-1746.
 [http://dx.doi.org/10.1056/NEJMoa011503] [PMID: 11742048]

[41]
Famularo, G.; Pino, G.P.; Minisola, G. Atrial septal defect and hyperhomocysteinemia: Two culprits for a cryptogenic stroke. Ann. Ital. Med. Int.,  2004, 19(4), 288-289.
 [PMID: 15678711]

[42]
Carerj, S.; Zito, C.; Oliva, S.; Tassone, G.; Luzza, F.; Oreto, G. Atrial septal aneurysm: A true embolic source? Italian Heart journal Supplement. Off. J. Itali. Federa. Cardiol.,  2005, 6(3), 135-144.

[43]
Serafini, O.; Misuraca, G.; Siniscalchi, A.; Manes, M.T.; Meringolo, G.; Tomaselli, C.; Chiatto, M.; Buffon, A. Prevalence of aneurysm of the interatrial septum in the general population and in patients with a recent episode of cryptogenetic ischemic stroke: a tissue harmonic imaging transthoracic echocardiography study in 5.631 patients. Monaldi Arch. Chest Dis.,  2006, 66(4), 264-269.
 [PMID: 17312845]

[44]
Silva, M.T.T.; Rodrigues, R.; Tress, J.; Victer, R.; Chamiê, F. Patent foramen ovale in a cohort of young patients with cryptogenic ischemic stroke. Arq. Neuropsiquiatr.,  2005, 63(2b), 427-429.
 [http://dx.doi.org/10.1590/S0004-282X2005000300012] [PMID: 16059593]

[45]
Pristipino, C.; Sievert, H.; D’Ascenzo, F.; Louis Mas, J.; Meier, B.; Scacciatella, P.; Hildick-Smith, D.; Gaita, F.; Toni, D.; Kyrle, P.; Thomson, J.; Derumeaux, G.; Onorato, E.; Sibbing, D.; Germonpré, P.; Berti, S.; Chessa, M.; Bedogni, F.; Dudek, D.; Hornung, M.; Zamorano, J.; D’Ascenzo, F.; Omedè, P.; Ballocca, F.; Barbero, U.; Giordana, F.; Gili, S.; Iannaccone, M.; Capodanno, D.; Valgimigli, M.; Byrne, R.; Akagi, T.; Carroll, J.; Dalvi, B.; Ge, J.; Kasner, S.; Michel-Behnke, I.; Pedra, C.; Rhodes, J.; Søndergaard, L.; Thomassen, L.; Biondi-Zoccai, G.G.L. European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism. Eur. Heart J.,  2019, 40(38), 3182-3195.
 [http://dx.doi.org/10.1093/eurheartj/ehy649] [PMID: 30358849]

Rights & Permissions Print Cite

Journal Information

For Authors

For Editors

For Reviewers

Explore Articles

Open Access

Open Access Articles

For Visitors

DOI https://dx.doi.org/10.2174/011871529X294809240415070950	Print ISSN 1871-529X
Publisher Name Bentham Science Publisher	Online ISSN 2212-4063

Cardiovascular & Hematological Disorders-Drug Targets

Atrial Septal Abnormalities and Cryptogenic Stroke: A Cross-Sectional Study

Abstract Play Pause

Graphical Abstract

Related Journals

Related Books

Abstract