Predictive value of transcranial Doppler bubble test combined with Hcy and NLR in patients with patent foramen ovale complicated with cryptogenic stroke
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Predictive value of transcranial Doppler bubble test combined with Hcy and NLR in patients with patent foramen ovale complicated with cryptogenic stroke
Medical Journal of Wuhan UniversityVol. 46, Issue 3, Pages: 392-396(2025)
YU Jiangyue,ZOU Yongguang,LI Pengfei,et al.Predictive value of transcranial Doppler bubble test combined with Hcy and NLR in patients with patent foramen ovale complicated with cryptogenic stroke[J].Medical Journal of Wuhan University,2025,46(03):392-396.
YU Jiangyue,ZOU Yongguang,LI Pengfei,et al.Predictive value of transcranial Doppler bubble test combined with Hcy and NLR in patients with patent foramen ovale complicated with cryptogenic stroke[J].Medical Journal of Wuhan University,2025,46(03):392-396.DOI: 10.14188/j.1671-8852.2023.0692.
Predictive value of transcranial Doppler bubble test combined with Hcy and NLR in patients with patent foramen ovale complicated with cryptogenic stroke
To evaluate the value of contrast transcranial Doppler (cTCD) combined with homocysteine (Hcy) and neutrophil/lymphocyte ratio (NLR) in the evaluation of cryptogenic stroke in patients with patent foramen ovale (PFO).
Methods
2
A total of 108 patients with PFO admitted to Xiaogan Hospital of Wuhan University of Science and Technology from June 2021 to June 2023 were selected
and 37 of them were complicated with cryptogenic. All patients underwent cTCD
blood routine
and homocysteine tests. NLR ratios were calculated according to lymphocyte and neutrophil count. According to the results of cTCD
the patients were divided into three groups: no shunt (grade 0)
small shunt (grade 1)
moderate shunt (grade 2)
and large shunt (grade 3) groups. The differences in RLS level
Hcy
and NLR ratios between PFO patients with and without cryptogenic stroke were compared. The value of PFO right to left shunt levels
Hcy
and NLR detection in evaluating PFO with cryptogenic stroke was analyzed by receiver operating characteristic (ROC) curve.
Results
2
The RLS level
Hcy
and NLR ratio were higher than those in patients without cryptogenic stroke (
P
<
0.05). The ROC showed that the area under the curve (
AUC
) of RLS level
Hcy
NLR
and combined diagnosis for PFO patients with cryptogenic stroke was 0.759
0.698
0.720
and 0.851
respectively. The Youden index of combined diagnosis was higher than that of each single index Conclusion
:
CTCD combined with Hcy and NLR helps evaluate the risk of PFO complicated with cryptogenic stroke.
WAN L S , SONG X J , LIU Y Y , et al . Advances on the relationship between migraine and patent foramen ovale [J ] . China J Mod Med , 2023 , 33 ( 10 ): 48 ‑ 54 .
ARSLAN A , YıLMAZ D Ç , ADıYAMAN M , et al . Study of transesophageal echocardiography in young patients with cryptogenic stroke: Prevalence of patent foramen ovale and interpretation of the RoPE score [J ] . Turk Kardiyol Dern Ars , 2022 , 50 ( 5 ): 314 ‑ 319 .
SHIMIZU T , UENO Y , TATEISHI Y , et al . Evaluating the potential pathology and short‑term outcomes of cryptogenic stroke using the etiological classification system [J ] . J Atheroscler Thromb , 2023 , 30 ( 4 ): 377 ‑ 389 .
VITARELLI A . Patent foramen ovale: Pivotal role of transesophageal echocardiography in the indications for closure, assessment of varying anatomies and post‑procedure follow‑up [J ] . Ultrasound Med Biol , 2019 , 45 ( 8 ): 1882 ‑ 1895 .
HANNA RYDER C , GIDRON Y , RYDER D , et al . The relationship between immune and inflammatory markers and short‑term clinical outcomes after stroke: Side matters [J ] . Isr Med Assoc J , 2023 , 25 ( 4 ): 298 ‑ 302 .
LI C Q , XING Y , ZHANG Y Q , et al . Neutrophil extracellular traps exacerbate ischemic brain damage [J ] . Mol Neurobiol , 2022 , 59 ( 1 ): 643 ‑ 656 .
AL HAMEED ALTAWEEL Y A , NAGEEB R S , METWALLY P M , et al . Role of some inflammatory biomarkers in prediction of short‑term outcome in acute ischemic stroke [J ] . Egypt J Neurol Psychiatry Neurosurg , 2021 , 57 ( 1 ): 41 .
ZHANG D , LIU Z , GUO W , et al . Serum homocysteine level is an independent risk factor for 1‑year stroke recurrence in patients with acute ischemic stroke and H‑type hypertension: results from the Xi'an stroke registry study of China [J ] . Front Neurol , 2023 , 14 : 1161318 .
ZHANG C , ZHENG L , ZHANG Y , et al . Comparison of stroke recurrence between antiplatelet and closure therapy in cryptogenic stroke patients with patent foramen ovale and its influencing factors [J ] . Eur J Intern Med , 2020 , 78 : 149 ‑ 151 .
Chinese Consensus Expert Group on the Clinical Application of Transesophageal Echocardiography . Expert consensus on agitated saline contrast echocardiography in the diagnosis of patent foramen ovale [J ] . Chin Circ J , 2022 , 37 ( 5 ): 449 ‑ 458 .
Chinese Society of Neurology , Chinese Stroke Society . Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018 [J ] . Chin J Neurol , 2018 , 51 ( 9 ): 666 ‑ 682 .
ZHANG C J , CHI J F , ZHENG L R , et al . Research progress on the treatment of cryptogenic stroke with patent foramen ovale [J ] . Chin J Intern Med , 2019 , 58 ( 9 ): 701 ‑ 704 .
EKKER M S , VERHOEVEN J I , SCHELLEKENS M M I , et al . Risk factors and causes of ischemic stroke in 1322 young adults [J ] . Stroke , 2023 , 54 ( 2 ): 439 ‑ 447 .
SAVER J L , CARROLL J D , THALER D E , et al . Long‑term outcomes of patent foramen ovale closure or medical therapy after stroke [J ] . N Engl J Med , 2017 , 377 ( 11 ): 1022 ‑ 1032 .
YAO Q , XIONG H , ZHANG D , et al . Synchronous multimode ultrasound for assessing right‑to‑left shunt: A prospective clinical study [J ] . Front Neurol , 2023 , 14 : 1148846 .
FOURCAND F , GADALLAH N , GHORI A , et al . Abstract 117: Contrast‑enhanced transcranial Doppler ultrasonography versus transesophageal echocardiography as screening tool in embolic stroke [J ] . Stroke , 2022 , 53 ( Suppl_1 ): 117 .
XU L , ZHOU C , LI J , et al . Correlation analysis between persistent right‑to‑left shunt of patent foramen ovale and cryptogenic stroke in young and middle‑aged adults [J ] . Chin Circ J , 2020 , 35 ( 2 ): 171 ‑ 175 .
RAMAZANOV G R , MAGOMEDOV T A , KHAMIDOVA L T , et al . Etiology of cryptogenic stroke [J ] . Neotložnaâ Med Pomoŝʹ , 2019 , 8 ( 3 ): 302 ‑ 314 .
ZHOU D , LI X L , HU H , et al . Clinical value of diagnostic biomarkers for patent foramen ovale‑associated stroke [J ] . J Clin Med Pract , 2023 , 27 ( 2 ): 134 ‑ 138 .
HU C , ZHAO B , YE Q , et al . The diagnostic value of the neutrophil‑to‑lymphocyte ratio and platelet‑to‑lymphocyte ratio for deep venous thrombosis: A systematic review and meta‑analysis [J ] . Clin Appl Thromb Hemost , 2023 , 29 : 10760296231187392 .
HE M , BI M , GAO S W , et al . Correlation of Hcy level and RDW value with cryptogenic stroke in patients with patent foramen ovale [J ] . Chin J Clin Res , 2023 , 36 ( 3 ): 347 ‑ 350 .
CAGLAR F N T , ALP M , KARABULUT D , et al . Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio are associated with cryptogenic stroke in patients with patent foramen ovale [J ] . Arch Med Sci Atheroscler Dis , 2020 , 5 ( 1 ): 112 ‑ 117 .
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