Evidence map›Paper›PMID 34006504›Full record

ArticleOpen heart2021

Right atrium and cryptogenic ischaemic stroke in the young: a case-control study.

Pauli Pöyhönen, Jouni Kuusisto, Jani Pirinen, Heli Räty, Lauri Lehmonen, Riitta Paakkanen, Nicolas Martinez-Majander, Eva Gerdts, Jukka Putaala, Juha Sinisalo and 1 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Open heart, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01934725 (Searching for Explanations for Cryptogenic Stroke in the Young), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.5field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01934725 active not recruitingnot on this map

Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO)

TypeobservationalSponsorSECRETO Study ConsortiumRan2013 to 2031Enrolled1,200ConditionsBrain Infarction, Ischemic Stroke, Thrombosis, Foramen Ovale, Patent
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 2 countries.

Pauli PöyhönenHeart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland pauli.poyhonen@helsinki.fi.ORCID 0000-0002-3031-5391
Jouni KuusistoHeart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Jani PirinenDepartment of Clinical Physiology and Nuclear Medicine, HUS Medical Imaging Center, Helsinki, Finland.
Heli RätyDepartment of Clinical Physiology and Nuclear Medicine, HUS Medical Imaging Center, Helsinki, Finland.
Lauri LehmonenRadiology, HUS Medical Imaging Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Riitta PaakkanenHeart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Nicolas Martinez-MajanderNeurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Eva GerdtsDepartment of Clinical Science, University of Bergen, Bergen, Norway.
Jukka PutaalaNeurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Juha SinisaloHeart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Vesa JärvinenDepartment of Clinical Physiology and Nuclear Medicine, HUS Medical Imaging Center, Helsinki, Finland.
University of Helsinki · FIHospital District of Helsinki and Uusimaa · FIUniversity of Bergen · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent studies suggest left atrial (LA) dysfunction in cryptogenic stroke. We studied the dynamics of right atrium (RA) and right atrial appendage (RAA) in young adults with cryptogenic stroke. We hypothesised that bi-atrial dysfunction and blood stagnation might contribute to thrombosis formation in patients with patent foramen ovale (PFO), as deep venous thrombosis is detected only in the minority of patients.

methodsThirty patients (aged 18-49) with a first-ever cryptogenic stroke and 30 age-matched and sex-matched stroke-free controls underwent cardiac magnetic resonance (CMR) imaging. An approach to estimate the RAA volume was developed, using crista terminalis and pectinate muscles as anatomical landmarks. Atrial expansion indices were calculated as (maximal volume - minimal volume) ×100%/minimal volume. Total pulmonary to systemic blood flow ratio (Qp/Qs) was based on phase contrast CMR. Right-to-left shunt (RLS) was evaluated with transoesophageal echocardiography in 29 patients and transcranial Doppler in 30 controls, moderate-to-severe RLS considered as clinically significant.

resultsWe found that RA and RAA volumes were similar between patients and controls. Also, RA expansion index was similar, but RAA (95.6%±21.6% vs 108.7%±25.8%, p=0.026) and LA (126.2%±28% vs 144.9%±36.3%, p=0.023) expansion indices were lower in patients compared with controls. Seven (24%) of 29 patients had an RLS compared with 1 (3%) of 30 controls (p=0.012). Among 59 study subjects, RLS was associated with lower RA (81.9%±15.9% vs 98.5%±29.5%, p=0.030), RAA (84.7%±18% vs 105.6%±24.1%, p=0.022), LA (109.8%±18.6% vs 140.1%±33.7%, p=0.017) and LAA (median 102.9% (IQR 65.6%-121.7%) vs 229.1% (151.8%-337.5%], p=0.002) expansion indices and lower Qp/Qs ratio (0.91±0.06 vs 0.98±0.07, p=0.027).

conclusionsThis study suggests bi-atrial dysfunction in young adults with cryptogenic stroke, associated with moderate-to-severe RLS. Dysfunction of the atria and atrial appendages may be an additional mechanism for PFO-related stroke. TRIAL REGISTRATION NUMBER: NCT01934725.

Indexed as

AdolescentAdultAtrial AppendageAtrial Function, RightCase-Control StudiesEchocardiography, TransesophagealFemaleHeart AtriaHumansIschemic StrokeMagnetic Resonance Imaging, CineMaleMiddle AgedUltrasonography, Doppler, TranscranialVentricular Dysfunction, RightYoung Adultechocardiographymagnetic resonance imagingstroke

Identifiers

PMID34006504
PMCPMC8137166
OpenAlexW3162928639

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.