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Provoked exercise desaturation in patent foramen ovale and impact of percutaneous closure.

dc.contributor.author Devendra, Ganesh P
dc.contributor.author Krasuski, Richard Andrew
dc.contributor.author Rane, AA
dc.coverage.spatial United States
dc.date.accessioned 2015-12-03T17:39:39Z
dc.date.issued 2012-04
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/22516398
dc.identifier S1936-8798(12)00096-9
dc.identifier.uri http://hdl.handle.net/10161/11017
dc.description.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.
dc.language eng
dc.relation.ispartof JACC Cardiovasc Interv
dc.relation.isversionof 10.1016/j.jcin.2012.01.011
dc.subject Adult
dc.subject Aged
dc.subject Biomarkers
dc.subject Cardiac Catheterization
dc.subject Chi-Square Distribution
dc.subject Echocardiography, Doppler
dc.subject Exercise Test
dc.subject Exercise Tolerance
dc.subject Female
dc.subject Foramen Ovale, Patent
dc.subject Humans
dc.subject Male
dc.subject Middle Aged
dc.subject Ohio
dc.subject Oximetry
dc.subject Oxygen
dc.subject Predictive Value of Tests
dc.subject Prospective Studies
dc.subject Prosthesis Design
dc.subject Recovery of Function
dc.subject Septal Occluder Device
dc.subject Time Factors
dc.subject Treatment Outcome
dc.title Provoked exercise desaturation in patent foramen ovale and impact of percutaneous closure.
dc.type Journal article
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/22516398
pubs.begin-page 416
pubs.end-page 419
pubs.issue 4
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Cardiology
pubs.organisational-group School of Medicine
pubs.publication-status Published
pubs.volume 5
dc.identifier.eissn 1876-7605


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