Sleep apnea syndrome and patent foramen ovale: a dangerous association in ischemic stroke? |
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| Affiliation: | 1. Neurology Department, Hospital Universitario Son Espases, Illes Balears, Spain;2. Pneumology Department, Sleep Unit, Hospital Universitario Son Espases, Illes Balears, Spain;3. Instituto de Investigación Hospital Universitario de la Princesa (IISP), Universidad Autónoma de Madrid, Madrid, Spain;1. Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Republic of Korea;2. Department of Neurology, Dankook University College of Medicine, Dankook University Hospital, Cheonan, Republic of Korea;1. Neurology Service, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain;2. CIBERNED, Barcelona, Spain;1. Hospital Moinhos de Vento (HMV), Porto Alegre, Rio Grande do Sul, Brazil;2. Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Brain Institute (InsCer), Porto Alegre, RS, Brazil;1. Department of Neurology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea;2. Department of Radiology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea;3. Department of Biomedical Engineering, Keimyung University School of Medicine, Daegu, Republic of Korea;4. Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, USA |
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| Abstract: | BackgroundThe coexistence of patent foramen ovale (PFO) and sleep apnea syndrome (SAS) might be related to the pathogenesis of cryptogenic stroke (CS). We aimed to determine the prevalence of SAS in patients with cryptogenic stroke and PFO.MethodsThis is a prospective case-control study in which we included ischemic stroke patients consecutively admitted to our hospital's Acute Stroke Unit. Contrast transcranial Doppler (c-TCD) and sleep polygraphy within the first 72 h after stroke onset were performed to detect PFO and SAS. Demographic and clinical characteristics, time of stroke onset, score in the National Institute of Health Stroke Scale (NIHSS), and stroke subtype were registered.ResultsA total of 97 patients were studied. Overall, 76% were men, with a mean ± SD age of 61 ± 13 years, and an NIHSS of 5 ± 5. Subtype of stroke was cryptogenic (CS) in 28 (29%) and non-CS in 69 (71%) of patients. PFO was more frequent among patients with CS (64% vs 29%, p = 0.002) and without SAS (60% vs 32%, p = 0.013). SAS was diagnosed in 74% of the whole group, with a higher prevalence in patients with known stroke etiology (83% vs 53%, p = 0.003). Finally, the prevalence of SAS and PFO coexistence was similar in patients with or without cryptogenic stroke (25% vs 22%, p = 1), and when comparing the group of patients with cryptogenic wake-up stroke to the other stroke patients (43% vs 21%, p = 0.35).ConclusionsAccording to our results, there is no evidence of an association of PFO and SAS in the pathogenesis of cryptogenic stroke. |
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