Aortic Root Downward Movement as a Novel Method for Identification of an Adequately Performed Valsalva Maneuver to Detect Patent Foramen Ovale during Transesophageal Echocardiograph

Chen, Lixin; Sheng, Yuanyuan; Huang, Yuxiang; Li, Jian; Liu, Xiaohua; Liu, Qian; Shi, Bobo; Zhong, Xiaofang; Xu, Jinfeng1; Liu, Yingying1

2022-04-01

10.3390/diagnostics12040980

DIAGNOSTICS   影响因子和分区

2075-4418

The Valsalva maneuver (VM) is the most sensitive auxiliary method for the detection of patent foramen ovale (PFO), but it is difficult to assess whether the maneuver is adequately performed during transesophageal echocardiography (TEE). In this study, we tried to use aortic root downward movement as a novel method for judging whether VM was adequate or not, and to evaluate whether this novel method can increase the sensitivity of detecting PFO. A total of 224 patients with clinically suspected PFO were enrolled in this study. These patients were injected with activated normal saline to detect the right-to-left shunt (RLS), in the following three conditions: contrast-enhanced transthoracic echocardiography under adequate VM (AVM cTTE), contrast-enhanced TEE under non-adequate VM (non-AVM cTEE), and cTEE under adequate VM (AVM cTEE). A novel method in which the aorta root moves downward (movement range >= 16 mm) in the cTEE judged whether AVM was performed. The PFO detection rate and sensitivity of AVM cTEE were better than that of non-AVM cTEE (detection rate: 108 PFOs [48.2%] vs. 86 PFOs [38.4%], p = 0.036; sensitivity: 100% vs. 79.6%). Among AVM cTTE, non-AVM cTEE, and AVM cTEE, the RLS grade evaluation results were inconsistent, with significant differences (p < 0.05). Non-AVM cTEE had RLS underestimation or false negatives. Compared with non-AVM cTEE, AVM cTEE and AVM cTTE had better consistency in evaluating PFO RLS (kappa value = 0.675). Aortic root downward movement could be used as a novel method for judging the effectiveness of VM, which is critical for the detection of PFO in cTEE. Concerning effectiveness and convenience, this method should be promoted during the clinical detection of PFO.

patent foramen ovale transesophageal echocardiography aortic root downward movement Valsalva maneuver

SCI

英语

其他

National Natural Science Foundation of China[81771841] ; Project of Innovation of the Science and Technology Commission of Shenzhen City[JCYJ20190807145609482]

General & Internal Medicine

Medicine, General & Internal

WOS:000785672000001

MDPI

Web of Science

1.Jinan Univ, Shenzhen Peoples Hosp, Shenzhen Med Ultrasound Engn Ctr, Dept Ultrasound,Clin Med Coll 2, Shenzhen 518020, Peoples R China
2.Southern Univ Sci & Technol, Affiliated Hosp 1, Shenzhen 518020, Peoples R China

Chen, Lixin,Sheng, Yuanyuan,Huang, Yuxiang,et al. Aortic Root Downward Movement as a Novel Method for Identification of an Adequately Performed Valsalva Maneuver to Detect Patent Foramen Ovale during Transesophageal Echocardiograph[J]. DIAGNOSTICS,2022,12(4).

Chen, Lixin.,Sheng, Yuanyuan.,Huang, Yuxiang.,Li, Jian.,Liu, Xiaohua.,...&Liu, Yingying.(2022).Aortic Root Downward Movement as a Novel Method for Identification of an Adequately Performed Valsalva Maneuver to Detect Patent Foramen Ovale during Transesophageal Echocardiograph.DIAGNOSTICS,12(4).

Chen, Lixin,et al."Aortic Root Downward Movement as a Novel Method for Identification of an Adequately Performed Valsalva Maneuver to Detect Patent Foramen Ovale during Transesophageal Echocardiograph".DIAGNOSTICS 12.4(2022).