Difference in infarct volume and long-term outcomes between patent foramen ovale and atrial fibrillation

초록

Purpose : Atrial fibrillation (AF) and patent foramen ovale (PFO) are established sources of cardioembolism. We investigated differences in stroke prognosis and patterns between PFO and AF. Methods : We performed a retrospective review of the medical records and brain MR image of patients with AF or PFO from the prospective acute stroke and transient ischemic attack registry. Infarct volume, NIHSS on admission, and existence of PFO were assessed in all patients. To minimize the effect of other stroke etiology like large artery atherosclerosis or small vessel occlusion, we analyzed the infarct volume and the clinical status in the patients with probable cardiac embolism, defined as territorial infarction without cerebral artery stenoocclusion or multiple vascular territorial infarction Results : From June 2005 to July 2008, a total of 289 subjects were enrolled (AF group, n=156; PFO group, n=133). Among the patients with probable cardiac embolism, the patients with PFO had the smaller infarct than those with AF. Compared to AF, the existence of PFO was the independent predictor for the better clinical status after adjusting old age, sex, and previous stroke history. Compared to AF, cerebral infarction related to PFO might be smaller and lead to better prognosis. Conclusions : These results suggested that different sources of cardioembolism would result in different infarct patterns and clinical status.