ArticleTherapeutic advances in neurological disorders2020
Prevalence of patent foramen ovale in the Greek population is high and impacts on the interpretation of the risk of paradoxical embolism (RoPE) score.
Article in Therapeutic advances in neurological disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 12 citations in OpenAlex.
- Transcranial doppler detected right-to-left shunt is common but not associated with MRI white matter hyperintensity burden: a cross-sectional study.European stroke journal · 2026Article
- Stroke recurrence after transcatheter PFO closure in patients with cryptogenic stroke.International journal of stroke : official journal of the International Stroke Society · 2025Article
- Article
- Prevalence and characteristics of patent foramen ovale in a sample of Egyptian population: a computed tomography study.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2024Article
- Article
- Atrial Septal Abnormalities and Cryptogenic Stroke: A Cross-Sectional Study.Cardiovascular & hematological disorders drug targets · 2024Article
- Association of Shunt Size and Long-Term Clinical Outcomes in Patients with Cryptogenic Ischemic Stroke and Patent Foramen Ovale on Medical Management.Journal of clinical medicine · 2023Article
- Connection between right-to-left shunt and photosensitivity: a community-based cross-sectional study.Frontiers in neurology · 2023Article
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6 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe risk of paradoxical embolism (RoPE) score calculates the probability that patent foramen ovale (PFO) is causally related to stroke (PFO attributable fraction, PFOAF), based on PFO prevalence in patients with cryptogenic stroke (CS) compared with that in the general population. The latter has been estimated at 25%; however, PFO prevalence in nonselected populations varies widely.
methodsSince PFO prevalence in Greece remains unknown, we evaluated it and we calculated PFOAF stratified by RoPE score in a cohort of patients with CS ⩽55 years old. PFO was detected according to the international consensus transcranial Doppler (TCD) criteria in 124 healthy subjects (H), in 102 patients with CS, and in 56 patients with stroke of known cause (nonCS). Each subject underwent unilateral middle cerebral artery recording after infusion of agitated saline, at rest, and after a controlled Valsalva maneuver. We characterized PFO as large (>20 microbubbles or curtain), moderate (11-20), and small (⩽10).
resultsPFO was detected in 42.7% of H, 49% of CS, and 25% of nonCS (
conclusionsPFO prevalence in the Greek population is much higher than the widely accepted 25%. PFO may be the cause of stroke in one out of nine Greek patients with CS. Among Greek CS patients who harbor a PFO, the latter is causal in one out of five. The established RoPE score cutoff of ⩾7 for having a probable PFO-associated stroke may overestimate the probability in patients deriving from populations with high PFO prevalence.
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