Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/16561
Title: Patent foramen ovale with atrial septal aneurysm is strongly associated with migraine with aura: a large observational study
Authors: Snijder, Roel JR;Luermans, Justin GLM;de Heij, Albert H;Thijs, Vincent;Schonewille, Wouter J;Van De Bruaene, Alexander;Swaans, Martin J;Budts, Werner IHL;Post, Martijn C
Issue Date: 1-Dec-2016
EDate: 2016-12-01
Citation: Journal of the American Heart Association 2016; 5(12): e003771
Abstract: A patent foramen ovale (PFO) with atrial septal aneurysm (ASA) has been identified as a risk factor for cryptogenic stroke. Patients with migraine with aura (MA) appear to be at risk for silent brain infarction, which might be related to the presence of a PFO. However, the association between MA and PFO with ASA has never been reported. We examined this association in a large observational study. METHODS AND RESULTS: Patients (>18 years) who underwent an agitated saline transesophageal echocardiography (cTEE) at our outpatient clinics within a timeframe of 4 years were eligible to be included. Before cTEE they received a validated headache questionnaire. Two neurologists diagnosed migraine with or without aura according to the International Headache Criteria. A total of 889 patients (mean age 56.4±14.3 years, 41.7% women) were included. A PFO was present in 23.2%, an isolated ASA in 2.7%, and a PFO with ASA in 6.9%. The occurrence of migraine was 18.9%; the occurrence of MA was 8.1%. The prevalence of PFO with ASA was significantly higher in patients with MA compared to patients without migraine (18.1% vs 6.1%; OR 3.72, 95% CI 1.86-7.44, P<0.001). However, a PFO without ASA was not significantly associated with MA (OR 1.50, 95% CI 0.79-2.82, P=0.21). Interestingly, a PFO with ASA was strongly associated with MA (OR 2.71, 95% CI 1.23-5.95, P=0.01). CONCLUSION: In this large observational study, PFO with ASA was significantly associated with MA only. PFO closure studies should focus on this specific intra-atrial anomaly.
URI: http://ahro.austin.org.au/austinjspui/handle/1/16561
DOI: 10.1161/JAHA.116.003771
PubMed URL: https://www.ncbi.nlm.nih.gov/pubmed/27930349
Type: Journal Article
Subjects: Atrial septal aneurysm
Cerebrovascular disorders
Echocardiography
Heart septal defect
Migraine
Patent foramen ovale
Appears in Collections:Journal articles

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