Beneficial effects of position on patent foramen ovale-induced right-to-left shunt by contrast transcranial Doppler ultrasonography
10.3760/cma.j.issn.1004-4477.2014.10.009
- VernacularTitle:体位在对比经颅多普勒超声检测卵圆孔未闭右向左分流中的影响
- Author:
Yaoxuan LI
;
Liyuan ZHOU
;
Guangwei WU
;
Hao LIANG
;
Yilan ZHAO
;
Chunxia CHEN
;
Lyuli LI
- Publication Type:Journal Article
- Keywords:
Echocardiography;
Ultrasonography,Dopper,transcranial;
Foramen ovale,palent;
Posture;
Right-to-left shunt
- From:
Chinese Journal of Ultrasonography
2014;23(10):857-860
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the influence on right-to-left shunt (RLS) of patent foramen ovale with contrast transcranial Dopple (cTCD) in different positions.Methods 276 consecutive patients included ischemic cerebrovascular disease (ICVD),migraine,episodic vertigo and syncope.They underwent cTCD at rest and after Valsalva maneuver in 4 positions:upright sitting,supine,left lateral decubitus and right lateral decubitus,in random order.RLS was graded 0 (no microbubbles detected),1 (1-10microbubbles),2 (＞ 10 microbubbles but no curtain),and 3 (curtain,shower of microbubbles).Meanwhile,each patients was examined by contrast transthoracic echocardiography(cTTE),contrast transesophageal echocardiography (cTEE) or right heart catheterization.Results RLS detection rate was 48.2％ (133/276)through cTCD.They were also confirmed patent foramen ovale by 82 cases in cTTE,28 cases in cTEE,and 23 patients in right heart catheterization.At rest,RLS detection rate and microbubbles of 4 positions had no significant difference (P ＞0.05).After the Valsalva maneuver,RLS detection rate and microbubbles of each position were significantly higher than at rest (P ＜0.001),and the RLS detection rate and microbubbles in upright sitting were higher than that at rest(P ＜0.05).Conclusions RLS is best detected in the upright sitting position with Valsalva maneuver with cTCD.Upright sitting detection helps to improve the detection rate and microbubbles of RLS.
