Key result
Permanent right-to-left shunting in patent foramen ovale was associated with lower left atrial vorticity magnitude compared to mild shunting (88.3 vs 101.12; p=0.02).
Why the study?
Does vorticity magnitude in the LA and LAA differ between patients with mild versus permanent right-to-left shunting in patent foramen ovale?
Observational (n=65)
Does vorticity magnitude in the LA and LAA differ between patients with mild versus permanent right-to-left shunting in patent foramen ovale?
Absolute Event Rate: 88.3% vs 101.12%
p-value: p=0.02
Patients with permanent right-to-left shunting in PFO have lower vorticity magnitude in the LA and LAA, suggesting higher blood stagnation similar to that seen in atrial fibrillation.
BACKGROUND: An impairment of the left atrial function similar to that usually observed in atrial fibrillation (AF) has been observed also in patients with patent foramen ovale (PFO) and permanent right-to-left shunting (RLS). METHODS: We reconstructed the geometrical model of right atrium (RA), PFO, left atrium (LA) and left atrial appendage (LAA) of 65 patients with mild (36 patients mean age 45.5±6.8 years, 24 females) or permanent (29 patients, mean age 45.1±5.3 years, 21 females) RLS using anatomical data obtained by transoesophageal echocardiography (TEE) and cardiac MRI, performed as a part of our institutional screening protocol for paradoxical embolism. Using computational fluid dynamic analysis (CFD) we assessed the vorticity magnitude in both the LA and LAA to analyse a possible rheological relationship between PFO and AF. RESULTS: The anatomical models, in terms of dimensions, were comparable among the patients with mild and permanent RLS. A higher vorticity magnitude was observed in the mild shunt both in the LA (101.12±21.3 vs 88.3±22.6, p=0.02) and LAA (62±14.4 vs 32.4±12.3, p<0.01) when compared to the permanent R-L shunting. CONCLUSION: The lower vorticity magnitude across the LA and LAA in patients with permanent RLS suggests a possible higher stagnation of the blood in these anatomical sites, similarly as previously observed in patients with AF.
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Gianluca Rigatelli (2018) conducted an observational in Patent foramen ovale with right-to-left shunting (n=65). Permanent right-to-left shunting vs. Mild right-to-left shunting was evaluated on Vorticity magnitude in the left atrium (p=0.02). Permanent right-to-left shunting in patent foramen ovale was associated with lower left atrial vorticity magnitude compared to mild shunting (88.3 vs 101.12; p=0.02).
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