切换至 "中华医学电子期刊资源库"

中华脑血管病杂志(电子版) ›› 2023, Vol. 17 ›› Issue (04) : 307 -311. doi: 10.11817/j.issn.1673-9248.2023.04.001

专家论坛

卵圆孔未闭相关血栓形成机制的研究进展
尹琛俊, 张喆, 李晓明()   
  1. 100191 北京,北京大学第三医院心脏外科
    100029 北京,首都医科大学附属北京安贞医院介入超声科
  • 收稿日期:2023-07-01 出版日期:2023-08-01
  • 通信作者: 李晓明
  • 基金资助:
    北京大学第三医院院临床重点项目(BYSYZD2022034)

Advance in mechanisms of patent foramen ovale-associated thrombosis

Chenjun Yin, Zhe Zhang, Xiaoming Li()   

  1. Department of Cardiac Surgery, Peking University Third Hospital, Beijing 100191, China
    Department of Interventional Ultrasound, Beijing anzhen hospital, Capital Medical University, Beijing 100029, China
  • Received:2023-07-01 Published:2023-08-01
  • Corresponding author: Xiaoming Li
引用本文:

尹琛俊, 张喆, 李晓明. 卵圆孔未闭相关血栓形成机制的研究进展[J/OL]. 中华脑血管病杂志(电子版), 2023, 17(04): 307-311.

Chenjun Yin, Zhe Zhang, Xiaoming Li. Advance in mechanisms of patent foramen ovale-associated thrombosis[J/OL]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2023, 17(04): 307-311.

卵圆孔未闭(PFO)是指原发隔和继发隔未能完全融合而留有缝隙样结构,与以血栓形成、栓塞为基础的隐源性卒中和偏头痛等疾病密切相关。充分了解PFO相关血栓形成的机制将有助于临床识别病理性PFO及进行个体化管理,使患者充分获益。本文拟从反常栓塞、原位血栓形成、左心房功能改变及血液高凝状态等方面对PFO相关血栓形成机制的研究进展进行综述,以期为后续PFO相关疾病的高危因素及预防策略研究提供理论基础。

Patent foramen ovale (PFO) refers to the gap-like structure left after the septum primum and septum secundum failed to fully fuse, which is closely related to cryptogenic stroke and migraine based on thrombosis and embolism. Gaining a comprehensive understanding of the underlying mechanisms of PFO-associated thrombosis will greatly contribute to the clinical identification of the pathology of PFO and individualized management, benefiting patients fully. This article reviewed the research progress on PFO-related thrombosis mechanisms from paradoxical embolism, in situ thrombosis, left atrial function changes to hypercoagulable state, providing a theoretical basis for the following research on high-risk factors and prevention strategies of PFO-related diseases.

1
Teshome MK, Najib K, Nwagbara CC, et al. Patent foramen ovale: a comprehensive review [J]. Curr Probl Cardiol, 2020, 45(2): 100392.
2
Mac Grory B, Ohman EM, Feng W, et al. Advances in the management of cardioembolic stroke associated with patent foramen ovale [J]. BMJ, 2022, 376: e063161.
3
Kavinsky CJ, Szerlip M, Goldsweig AM, et al. SCAI guidelines for the management of patent foramen ovale [J]. Journal of the Society for Cardiovascular Angiography & Interventions, 2022, 1(4): 100039.
4
Windecker S, Stortecky S, Meier B. Paradoxical embolism [J]. J Am Coll Cardiol, 2014, 64(4): 403-415.
5
Cvetković D, Živković V, Nikolić S. Patent foramen ovale, paradoxical embolism and fatal coronary obstruction [J]. Forensic Sci Med Pathol, 2018, 14(2): 258-262.
6
Bai H, Cho LD, Cooke PV, et al. Endovascular intervention for May-Thurner syndrome in a pregnant patient with a patent foramen ovale and paradoxical embolism [J]. Vasc Endovascular Surg, 2022, 56(5): 517-520.
7
Bova C, Calcaterra R, De Vuono A, et al. Pulmonary embolism and renal artery thrombosis in a patient with patent foramen ovale [J]. Acta Biomed, 2022, 93(S1): e2022209.
8
Kouskov OS, Nichols DJ, O’Hearn DJ. Paradoxical arterial embolism involving both upper extremities in a patient with pulmonary embolism and a patent foramen ovale [J]. Clin Appl Thromb Hemost, 2011, 17(6): E98-E101.
9
Rigatelli G, Dell’Avvocata F, Cardaioli P, et al. Shut that door: a man with contemporaneous multisite paradoxical embolization [J]. Cardiovasc Revasc Med, 2009, 10(2): 125-127.
10
Thanigaraj S, Zajarias A, Valika A, et al. Caught in the act: serial, real time images of a thrombus traversing from the right to left atrium across a patent foramen ovale [J]. Eur J Echocardiogr, 2006, 7(2): 179-181.
11
Pires MIFB, Almeida I, Santos JM, et al. Thrombus in transit through a patent foramen ovale: catch it if you can-a case report [J]. Eur Heart J Case Rep, 2021, 5(10): ytab382.
12
Härtl J, Berndt M, Poppert H, et al. Histology of cerebral clots in cryptogenic stroke varies according to the presence of a patent foramen ovale [J]. Int J Mol Sci, 2022, 23(16): 9474.
13
Benvenuti F, Meucci F, Vuolo L, et al. Relation between the size of patent foramen ovale and the volume of acute cerebral ischemic lesion in young patients with cryptogenic ischemic stroke [J]. Neurol Sci, 2022, 43(1): 453-458.
14
Le Moigne E, Timsit S, Ben Salem D, et al. Patent foramen ovale and ischemic stroke in patients with pulmonary embolism: a prospective cohort study [J]. Ann Intern Med, 2019, 170(11): 756-763.
15
Di Stefano V, Di Fulvio M, Di Liberato L, et al. Paradoxical embolism through a patent foramen ovale from central venous catheter thrombosis: a potential cause of stroke [J]. J Neurol Sci, 2020, 414: 116820.
16
Osgood M, Budman E, Carandang R, et al. Prevalence of pelvic vein pathology in patients with cryptogenic stroke and patent foramen ovale undergoing MRV pelvis [J]. Cerebrovasc Dis, 2015, 39(3-4): 216-223.
17
Lamy C, Giannesini C, Zuber M, et al. Clinical and imaging findings in cryptogenic stroke patients with and without patent foramen ovale: the PFO-ASA study. Atrial septal aneurysm [J]. Stroke, 2002, 33(3): 706-711.
18
Samuel S, Reddy ST, Parsha KN, et al. Routine surveillance of pelvic and lower extremity deep vein thrombosis in stroke patients with patent foramen ovale [J]. J Thromb Thrombolysis, 2021, 51(4): 1150-1156.
19
Sc C, Jh M, Gm W, et al. Paradoxical emboli from calf and pelvic veins in cryptogenic stroke [J]. J Neuroimaging, 2003, 13(3): 218-223.
20
Wessler BS, Thaler DE, Ruthazer R, et al. Transesophageal echocardiography in cryptogenic stroke and patent foramen ovale: analysis of putative high-risk features from the risk of paradoxical embolism database [J]. Circ Cardiovasc Imaging, 2014, 7(1): 125-131.
21
Thaler DE, Ruthazer R, Weimar C, et al. Recurrent stroke predictors differ in medically treated patients with pathogenic vs. other PFOs [J]. Neurology, 2014, 83(3): 221-226.
22
Yan C, Li H. Preliminary investigation of in situ thrombus within patent foramen ovale in patients with and without stroke [J]. JAMA, 2021, 325(20): 2116-2118.
23
潘双杰, 何远宏, 赵源征, 等. 中性粒细胞与淋巴细胞的比值与卵圆孔未闭患者卒中相关性研究 [J]. 中国现代医生, 2021, 59(18): 91-94.
24
Lezcano EJ, Ruiz JR, Lacambra I. Device thrombosis during the percutaneous closure of a patent foramen ovale [J]. Rev Esp Cardiol, 2011, 64(6): 540-541.
25
Rigatelli G, Zuin M, Dell’Avvocata F, et al. Light anti-thrombotic regimen for prevention of device thrombosis and/or thrombotic complications after interatrial shunts device-based closure [J]. Eur J Intern Med, 2020, 74: 42-48.
26
Blanc-Vannet S, Vautrin E, Piliero N. Massive device thrombosis, multiple embolisms, and delayed-onset heparin-induced thrombocytopenia: a rare but severe complication of patent foramen ovale closure [J]. Eur Heart J, 2022, 43(25): 2425.
27
Aarnink EW, Huijboom MFM, Bor WL, et al. Hemostatic biomarkers and antithrombotic strategy in percutaneous left atrial interventions: State-of-the-art review [J]. Thromb Res, 2022, 215: 41-51.
28
Sun H, Zhou C, Xu L, et al. A meta-analysis of the association of atrial septal abnormalities and atrial vulnerability [J]. Medicine, 2021, 100(35): e27165.
29
Acampa M, Lazzerini PE, Guideri F, et al. Electrocardiographic predictors of silent atrial fibrillation in cryptogenic stroke [J]. Heart Lung Circ, 2019, 28(11): 1664-1669.
30
徐振兴. 阵发性室上性心动过速患者房颤的心房易损性及其影响因素 [D]. 济南: 山东大学, 2014.
31
Cotter PE, Martin PJ, Pugh PJ, et al. Increased incidence of interatrial block in younger adults with cryptogenic stroke and patent foramen ovale [J]. Cerebrovasc Dis Extra, 2011, 1(1): 36-43.
32
Berthet K, Lavergne T, Cohen A, et al. Significant association of atrial vulnerability with atrial septal abnormalities in young patients with ischemic stroke of unknown cause [J]. Stroke, 2000, 31(2): 398-403.
33
Rigatelli G, Aggio S, Cardaioli P, et al. Left atrial dysfunction in patients with patent foramen ovale and atrial septal aneurysm [J]. JACC Cardiovasc Interv, 2009, 2(7): 655-662.
34
Mahfouz RA, Alawady WS, Salem A, et al. Atrial dyssynchrony and left atrial stiffness are risk markers for cryptogenic stroke in patients with patent foramen ovale [J]. Echocardiography, 2017, 34(12): 1888-1894.
35
Rigatelli G, Zuin M, Fong A. Computational flow dynamic analysis of right and left atria in patent foramen ovale: potential links with atrial fibrillation [J]. J Atr Fibrillation, 2018, 10(5): 1852.
36
Rigatelli G, Zuin M, Roncon L. Increased blood residence time as markers of high-risk patent foramen ovale [J]. Transl Stroke Res, 2023, 14(3): 304-310.
37
Guedeney P, Laredo M, Zeitouni M, et al. Supraventricular arrhythmia following patent foramen ovale percutaneous closure [J]. JACC Cardiovasc Interv, 2022, 15(22): 2315-2322.
38
Apostolos A, Drakopoulou M, Gregoriou S, et al. Supraventricular arrhythmia after percutaneous PFO closure: is nickel hypersensitivity the missing piece of the puzzle? [J]. JACC Cardiovasc Interv, 2023, 16(3): 359.
39
Andersen A, Matzen KL, Andersen G, et al. Atrial fibrillation after closure of patent foramen ovale in the REDUCE clinical study [J]. Catheter Cardiovasc Interv, 2022, 99(5): 1551-1557.
40
周建军, 胡娅莉. 易栓症的发生机制和防治 [J]. 中国实用妇科与产科杂志, 2009, 25(5): 332-335.
41
Carano N, Agnetti A, Hagler DJ, et al. Acute myocardial infarction in a child: possible pathogenic role of patent foramen ovale associated with heritable thrombophilia [J]. Pediatrics, 2004, 114(2): e255-e258.
42
Botto N, Spadoni I, Giusti S, et al. Prothrombotic mutations as risk factors for cryptogenic ischemic cerebrovascular events in young subjects with patent foramen ovale [J]. Stroke, 2007, 38(7): 2070-2073.
43
Giardini A, Donti A, Formigari R, et al. Comparison of results of percutaneous closure of patent foramen ovale for paradoxical embolism in patients with versus without thrombophilia [J]. Am J Cardiol, 2004, 94(8): 1012-1016.
44
Hviid CVB, Simonsen CZ, Hvas AM. Recurrence risk in patients with cryptogenic stroke, patent foramen ovale, and thrombophilia: a systematic review and meta-analysis [J]. Thromb Haemost, 2019, 119(11): 1839-1848.
45
Liu K, Song B, Palacios IF, et al. Patent foramen ovale attributable cryptogenic embolism with thrombophilia has higher risk for recurrence and responds to closure [J]. JACC Cardiovasc Interv, 2020, 13(23): 2745-2752.
46
樊黎明. 血浆高同型半胱氨酸与脑卒中的关系与干预进展 [J]. 中国误诊学杂志, 2021, 16(4): 383-384.
47
Deng W, McMullin D, Inglessis-Azuaje I, et al. Effect of patent foramen ovale closure after stroke on circulatory biomarkers [J]. Neurology, 2021, 97(2): e203-e214.
48
Zuin M, Rigatelli G, Rigatelli A, et al. Correlations between serum homocysteine levels and RoPE score in patients with patent foramen ovale [J]. Heart and Vessels, 2020, 35(5): 705-711.
49
Omran SS, Lerario MP, Gialdini G, et al. Clinical impact of thrombophilia screening in young adults with ischemic stroke [J]. J Stroke Cerebrovasc Dis, 2019, 28(4): 882-889.
50
Buber J, Guetta V, Orion D, et al. Patent foramen ovale closure among patients with hypercoagulable states maintained on antithrombotic therapy [J]. Cardiology, 2021, 146(3): 375-383.
[1] 陶宏宇, 叶菁菁, 俞劲, 杨秀珍, 钱晶晶, 徐彬, 徐玮泽, 舒强. 右心声学造影在儿童右向左分流相关疾病中的评估价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(10): 959-965.
[2] 于桐, 孙姗姗, 刘扬. 乳腺导管原位癌的浸润转化机制及临床病理特征[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(05): 304-307.
[3] 李蓉. 薄型子宫内膜治疗新方法[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 591-591.
[4] 严华悦, 刘子祥, 周少波. 磷酸烯醇式丙酮酸羧激酶-1在恶性肿瘤中的研究进展[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 452-456.
[5] 刘璐璐, 何羽. 慢性阻塞性肺病患者睡眠障碍的研究进展[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 836-839.
[6] 袁园园, 岳乐淇, 张华兴, 武艳, 李全海. 间充质干细胞在呼吸系统疾病模型中肺组织分布及治疗机制的研究进展[J/OL]. 中华细胞与干细胞杂志(电子版), 2024, 14(06): 374-381.
[7] 王庭宇, 邵联波, 刘珊, 沈振亚. Stanford A 型主动脉夹层相关基因KIF20A 的共表达网络构建及作用靶点分析[J/OL]. 中华细胞与干细胞杂志(电子版), 2024, 14(05): 303-312.
[8] 赵泽云, 李建男, 王旻. 中性粒细胞胞外诱捕网在结直肠癌中的研究进展[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 524-528.
[9] 王梦琪, 刘恒昌, 陈海鹏, 刘佳. 骶神经刺激治疗排便失禁的机制研究进展[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(05): 417-422.
[10] 赵静, 张嘉欣, 高言, 谢席胜. 微小病变肾病的发病机制及治疗研究进展[J/OL]. 中华肾病研究电子杂志, 2024, 13(04): 207-212.
[11] 陈利, 杨长青, 朱风尚. 重视炎症性肠病和代谢相关脂肪性肝病间的串话机制研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(05): 385-389.
[12] 刘琦, 王守凯, 王帅, 苏雨晴, 马壮, 陈海军, 司丕蕾. 乳腺癌肿瘤内微生物组的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 841-845.
[13] 徐靖亭, 孔璐. PARP抑制剂治疗卵巢癌的耐药机制及应对策略[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 584-588.
[14] 耿晓坤. 缺血性卒中后无效再灌注的时间窗、组织窗与神经保护[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(06): 636-636.
[15] 曹亚丽, 高雨萌, 张英谦, 李博, 杜军保, 金红芳. 儿童坐位不耐受的临床进展[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 510-515.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?