Article ID Journal Published Year Pages File Type
5978563 International Journal of Cardiology 2011 4 Pages PDF
Abstract

ObjectiveWe aimed to evaluate the effectiveness of transthoracic saline contrast echocardiography (TSCE) in detecting patent foramen ovale (PFO).BackgroundTransesophageal echocardiography (TEE) is semi-invasive and not ideal for PFO screening.Methods112 patients (48 males, 46 ± 14 years) with suspected PFO received intravenous agitated-saline contrast at rest and stress (strain and release phases of Valsalva maneuver and coughing). The presence of interatrial shunting was defined as > 5 bubbles appearing in the left heart within 3 cardiac cycles. The stage of the maneuver at which interatrial shunting occurred was recorded. The TSCE findings were validated by TEE.ResultsTEE identified PFO in 45% of patients. The sensitivities of TSCE in detecting PFO at rest, during strain and release of Valsalva maneuver, and coughing were 12.0%, 38.0%, 80.0% and 94.0% respectively (each p < 0.05 when compared to previous stage). Specificities were similar and > 95% for all stages. Moreover, the release phase of the maneuver improved the diagnostic accuracy [defined as (number of true positives + true negatives) divided by total in sample] with incremental value over the preceding strain phase (89.2 vs. 70.5%, p < 0.001).ConclusionsPatent foramen ovale can be identified confidently with proper conduct of the Valsalva maneuver during the transthoracic saline contrast echocardiography.

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