Study On The Correlation Between Stroke And Right Atrial Pressure Increased

ObjectiveThis research is to study the relativity of PFO and the daily activity that can make right atrium pressure rise(such as abdominal belt, sighs, weight lifting). To investigate the correlation between PFO and cryptogenic stroke, and to study the correlation between the right atrium pressure rise and stroke.MethodsCollect 122 cases of positive patients by the routine TCD foaming test. The 41 patients carried on TCD foaming test in the case of abdominal belt, the other 41 patients carried on TCD foaming test in the case of sighs, another 40 patients carried on TCD foaming test in the case of weight lifting. Record the right to left shunting of the above three cases, and compare with the normal TCD foam test. Collect 32 cases of cryptogenic stroke patients and 50 cases of healthy persons in Xianyang Hospital of Yan’an University from August 2015 to March 2016. The positive rate of TCD foaming test and the flow rate of the right to left of each group was recorded. SPSSl8.0 statistical software was used for statistical treatment. The measurement data are expressed by average plus or minus standard deviation, Variance test was used for compare between groups.The count data expressed by case number and percentage, The Chi-square test was used in the compare between groups. In the same control group and three different situation cases,ranked data of right to left shunt use two independent samples to do K-S test,Comparison of measurement data using t test, Chi-square test, calibration X2 test or Fisher’s exact probability method was used in the positive rate of TCD foaming and flow rate of the right to left of each group,α=0.05 was testing standard.Results1. Daily activities such as tight abdominal belt、sigh、weight can lead to right to left shunt, and the flow rate is more than resting, especially the flow rate increased obviouslyat the condition of sighing.2. 23 cases of TCD foaming test is positive at abdominal belt condition, the positive rate was 56.10%, 34 cases of TCD foaming test is positive at sighing condition, positive rate was 82.93%, 22 cases of TCD foaming test is positive at weightlifting condition, the positive rate was 55.00%. The difference is significant in statistics, which compare the positive rate between sigh group and abdominal belt group or a weightlifting group,(X2=10.5,7.40;P<0.01). The difference is insignificant in statistics, which compare the positive rate between abdominal belt group and weightlifting group(X2=0.314,P>0.05).3. The result of abdominal belt group : K-S test was performed on the ranked data between the right to left shunt which the patients have Valsalval activity and the right to left shunt at rest or tight abdominal, the difference is significant in statistics P<0.001(Z=2.761, 2.540), K-S test was performed on the ranked data between the right to left shunt which the patients at rest and tight abdominal, the difference is insignificant in statistics Z=2.773, P=0.589.The result of sigh group : K-S test was performed on the ranked data between any two right to left shunt conditions which is include Valsalval activity, rest and sigh, The difference is significant in statistics P<0.001(Z=2.982, 1.438,1.818). The result of weight lifting group : K-S test was performed on the ranked data between the right to left shunt which Valsalval activity and rest or weight lifting, and the difference is significant in statistics, P<0.001(Z=2.571, 2.012); K-S test was performed on the ranked data between the right to left shunt which at resting and the weight lifting,and the difference is significant in statistics(Z=0.559,P=0.913).4. Among 27 patients with stroke group, 19 cases(70.37%) of TCD foaming test is negative, 8 were positive(29.63%). Among 21 patients with cryptogenic stroke, 12 cases(57.14%) of TCD foaming test is negative, 9 were positive(42.86%). Among 30 healthy volunteers, 22 cases(73.33%) of TCD foaming test is negative, 8 were positive(26.67%).5. The positive rates, large RLS rates in the cryptogenic stroke is higher than thehealthy groups(p<0.05), There was no difference between the two groups among small RLS. The positive rates, large RLS rates in the cryptogenic stroke is higher than the stroke groups(p<0.05), There was no difference between the two groups among small RLS. There was no difference between stroke groups and healthy groups among positive rates, large RLS rates and small RLS.Conclusion1. Daily activities such as tight abdominal belt,sigh,weight can lead to right to left shunt;2. The influence that different daily activities lead the right to left shunt is different;3、The positive rates, large RLS rates in the cryptogenic stroke is higher than the healthy groups.