Preliminary Study On Patent Foramen Ovale In Patients With Migraine By Transthoracic Contrast Echocardiography

Objective: The aim of this study is to investigate incidence of PFO-RLS in migraine with aura and migraine without aura by transthoracic echocardiography and transthoracic contrast echocardiography,analysis the relation between MA and PFO,discuss the clinical value of transthoracic contrast echocardiography in the diagnosis of RLS,thus providing theoretical basis for clinical preventive treatment and prognostic assessment of migraine.Methods: The samples were randomly chosen from the the first affiliated hospital of Wannan Medical College in the neurology clinic from December 2014 to December 2015,18 patients of migraine with aura and 24 patients of migraine without aura.Observe the situation of PFO by two-dimensional and color doppler echocariography from the apical four chamber?four chamber subcostal and two chamber subcostal view,including the level and directions of shunt flow on atrial septal.Interruption of atrial septal echo continuity,echo separation or small bloodstream moves diagonally on atrial septal can be diagnosed as PFO-LRS.Set up intravenous access on antecubital vein and inject hand agitated microbubbles fleetness,then observe the number of the ultrasound contrast agent appeared in the left atrium from the apical four chamber view.The number of ultrasound contrast microbubbles are greater than 3,that can be diagnosed as PFO-RLS.Observe occurrence of PFO-RLS blow the resting state and Valsalva action.The contrast agent was prepared by agitating 1 m L of air with 9 m L of sterile saline solution using two 10 m L syringes and a 3-way stopcock,then mix them into mikly suspension by pushing syringes back and forth twenty.Results: The results of cTTE: the PFO-RLS patients of resting state in MA group were 1 cases,the PFO-RLS patients of Valsalva action in MA group were 7 cases.The PFO-RLS patients of Valsalva action in MO group were 0 cases;The PFO-RLS patients of resting state in control group were 6 cases.The positive rate of PFO-RLS of MA and MO group after the Valsalva action was significantly higher than that of the resting state detection,the difference was statistically significant(P<0.05).The results of TTE and cTTE: the PFO-RLS positive patients of MA group were 0 and 7 cases;the PFO-RLS positive patients of MO group were 0 and 6 cases.The difference of two examination techniques to dectect PFO-RLS in each groups was statistically significant(P<0.05).Conclusion: cTTE can detect migraine with aura and migraine without aura PFO-RLS effective.The positive rate of PFO-RLS of MA and MO group after the Valsalva action was significantly higher than that of the resting state detection.cTTE under the Valsalva action can be used routinely in diagnosis or screening of PFO-RLS,providing reference to identifing the etiology of sickness,choosing clinical therapeutic regimen and prognostic evaluation.