经食管超声心动图结合右心声学造影诊断老年卵圆孔未闭的特征分析

doi:10.3969/j.issn.1003-9198.2026.06.011

Abstract

Abstract: Objective To investigate the utility of transesophageal echocardiography combined with agitated saline contrast echocardiography in the diagnosis of patent foramen ovale (PFO) in elderly patients and to evaluate the clinical characteristics of PFO. Methods A total of 769 patients with PFO admitted to Echocardiography Department of the First Affiliated Hospital with Nanjing Medical University from June 2022 to June 2024 were included. They were divided into the young and middle-aged group (<60 years old) and the elderly group (≥ 60 years old). The clinical data, PFO shunt degree and cardiac structural characteristics of the two groups were compared. The correlation between clinical characteristics and shunt degree was analyzed, and the implementation situation of the transcatheter closure procedure and the follow-up results in the elderly group were recorded. Results The study included 652 patients in the young and middle-aged group and 117 patients in the elderly group. The elderly group had a higher prevalence of hypertension, cerebral infarction, and atrial fibrillation, but a lower incidence of headache/migraine compared with the young and middle-aged group (all P<0.01). There were no significant differences in gender or the occurrence of transient ischemic attack (P>0.05). Moderate-to-large PFO shunts (grade Ⅱ+grade Ⅲ) were less common in the elderly group,and there was a negative correlation between age and the degree of shunt (r=0.117, P<0.01). Left atrial enlargement was more frequent in the elderly group (P<0.01), whereas no significant differences were observed in the incidence of atrial septal aneurysm or pulmonary hypertension. The elderly group who underwent the transcatheter closure procedure had a lower stroke recurrence rate, and a higher headache/migraine relief rate within one year after the procedure compared to those who did not undergo transcatheter closure procedure (P<0.01). Conclusions Elderly patients with PFO exhibit distinct and clinically complex characteristics. The combined use of transesophageal echocardiography and agitated saline contrast echocardiography supports optimized, individualized diagnostic and therapeutic strategies for elderly patients with PFO.

Key words: transesophageal echocardiography, agitated saline contrast echocardiography, patent foramen ovale, right-to-left shunt, aged

CLC Number:

R 541.1

XU Yufeng, ZHOU Min, SHEN Xin, YONG Yonghong. Transesophageal echocardiography combined with agitated saline contrast echocardiography in the diagnosing and characteristic analysis of elderly patients with patent foramen ovale[J]. Practical Geriatrics, 2026, 40(6): 597-601.

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Transesophageal echocardiography combined with agitated saline contrast echocardiography in the diagnosing and characteristic analysis of elderly patients with patent foramen ovale

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