ALERT: This system is being upgraded on Tuesday December 12. It will not be available
for use for several hours that day while the upgrade is in progress. Deposits to DukeSpace
will be disabled on Monday December 11, so no new items are to be added to the repository
while the upgrade is in progress. Everything should be back to normal by the end of
day, December 12.
Provoked exercise desaturation in patent foramen ovale and impact of percutaneous closure.
Abstract
OBJECTIVES: This study was designed to assess the prevalence of provoked exercise
desaturation (PED) in patients with patent foramen ovale (PFO) referred for cardiovascular
evaluation and to evaluate the impact of PFO closure. BACKGROUND: Platypnea orthodeoxia
syndrome is a rare, mechanistically obscure consequence of PFO that results in oxygen
desaturation during postural changes. In our clinical experience, however, it is far
less common than desaturation during exercise. METHODS: This was a single-center prospective
study of 50 patients with newly diagnosed PFO. Each patient underwent standardized
assessment for arterial oxygen saturation with pulse oximetry during postural changes
and stair climbing exercise. Provoked exercise desaturation was defined as a desaturation
of at least 8% from baseline to <90%. All patients who underwent closure were reevaluated
3 months after the procedure. Those with baseline PED were similarly reassessed for
desaturation at follow-up. RESULTS: Mean age of the cohort was 46 ± 17 years, 74%
were female, 30% had migraines, and 48% had experienced a cerebrovascular event. Seventeen
patients (34%) demonstrated PED. Provoked exercise desaturation patients seemed demographically
similar to non-PED patients. Ten PED patients underwent PFO closure (2 surgical, and
8 percutaneous). Drop in oxygen saturation was improved by an average of 10.1 ± 4.2%
after closure (p < 0.001), and New York Heart Association functional class improved
by a median of 1.5 classes (interquartile range: 0.75 to 2.00, p = 0.008). CONCLUSIONS:
One-third of patients referred for assessment of PFO experience oxygen desaturation
during stair exercise. Closure of PFO seems to ameliorate this phenomenon and improve
functional status.
Type
Journal articleSubject
AdultAged
Biomarkers
Cardiac Catheterization
Chi-Square Distribution
Echocardiography, Doppler
Exercise Test
Exercise Tolerance
Female
Foramen Ovale, Patent
Humans
Male
Middle Aged
Ohio
Oximetry
Oxygen
Predictive Value of Tests
Prospective Studies
Prosthesis Design
Recovery of Function
Septal Occluder Device
Time Factors
Treatment Outcome
Permalink
https://hdl.handle.net/10161/11017Published Version (Please cite this version)
10.1016/j.jcin.2012.01.011Publication Info
Devendra, Ganesh P; Rane, Ajinkya A; & Krasuski, Richard A (2012). Provoked exercise desaturation in patent foramen ovale and impact of percutaneous
closure. JACC Cardiovasc Interv, 5(4). pp. 416-419. 10.1016/j.jcin.2012.01.011. Retrieved from https://hdl.handle.net/10161/11017.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
Collections
More Info
Show full item recordScholars@Duke
Richard Andrew Krasuski
Professor of Medicine
Dr. Richard Krasuski is Director of the Adult Congenital Heart Center at Duke University
Medical Center, the Director of Hemodynamic Research, and the Medical Director of
the CTEPH Program. He is considered a thought leader in the fields of pulmonary hypertension
and congenital heart disease. His research focus is in epidemiologic and clinical
studies involving patients with pulmonary hypertension and patients with congenital
heart disease. He is involved in multiple multicenter studies thr

Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy
Rights for Collection: Scholarly Articles
Works are deposited here by their authors, and represent their research and opinions, not that of Duke University. Some materials and descriptions may include offensive content. More info