Journal of Neurology

, Volume 260, Issue 1, pp 189–196

Patent foramen ovale and atrial septal aneurysm can cause ischemic stroke in patients with antiphospholipid syndrome

  • Yasutaka Tanaka
  • Yuji Ueno
  • Nobukazu Miyamoto
  • Yoshiaki Shimada
  • Ryota Tanaka
  • Nobutaka Hattori
  • Takao Urabe
Original Communication

Abstract

The purpose of the present study was to evaluate the contributions of embolic etiologies, patent foramen ovale (PFO) and atrial septal aneurysm (ASA) to the pathogenesis of ischemic stroke in patients with antiphospholipid syndrome (APS). We performed transesophageal echocardiography (TEE) examination for consecutive stroke patients who had been diagnosed with APS (APS group) to detect potential embolic sources. APS was diagnosed based on the modified Sapporo criteria. The control stroke group comprised age- and sex-matched cryptogenic stroke patients undergoing TEE. We assessed and compared the clinical characteristics and TEE findings between stroke patients with APS and control stroke groups. Among 582 patients, nine patients (nine women; mean age, 50 ± 18 years) were classified into the APS group. In 137 patients undergoing TEE, 41 age-matched female stroke patients were recruited to the control stroke group. Prevalences of PFO and ASA were significantly higher in the APS group than in the control stroke group (89 vs. 41 %, p = 0.027; 67 vs. 20 %, p = 0.015, respectively). Multiple logistic regression analysis showed that PFO (odds ratio (OR), 13.71; 95 % confidence interval (CI), 1.01–185.62; p = 0.049) and ASA (OR, 8.06; 95 % CI, 1.17–55.59; p = 0.034) were independently associated with the APS group. PFO and ASA were strongly associated with the APS group, and could thus represent potential embolic sources in ischemic stroke patients with APS.

Keywords

Patent foramen ovale Atrial septal aneurysm Antiphospholipid syndrome Transesophageal echocardiography Embolic stroke 

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Yasutaka Tanaka
    • 1
  • Yuji Ueno
    • 1
  • Nobukazu Miyamoto
    • 1
  • Yoshiaki Shimada
    • 1
  • Ryota Tanaka
    • 1
  • Nobutaka Hattori
    • 1
  • Takao Urabe
    • 1
  1. 1.Department of NeurologyJuntendo University, School of MedicineTokyoJapan

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