超声评价下腔静脉血流参数与卵圆孔未闭临床症状的相关性分析OA

Objective:To explore the relationship between inferior vena cava blood flow parameters and patent foramen ovale(PFO)related clinical symptoms.Methods:A total of 214 patients with PFO in our hospital from December 2020 to December 2022 were collected.Transthoracic echocardiography(TTE)was first performed to observe the cardiac structure and function,and other structural heart diseases,intracardiac space-occupying lesions,pulmonary hypertension and other lesions were excluded.The blood flow velocity of the inferior vena cava at rest and during the Valsalva maneuver was measured(measured at a distance of 1 cm from the entrance of the right atrium).Then,contrast transthoracic echocardiography(cTTE)was performed to observe the presence of microbubbles in the left atrium and determine whether the microbubbles in the left atrium originated from the right atrium.Transesophageal echocardiography(TEE)was then performed to measure the distance between the entrance of the inferior vena cava and the foramen ovale at rest and during the Valsalva maneuver(the distance from the entrance of the inferior vena cava into the right atrium to the opening of the foramen ovale on the right atrial side)and the angle between the axis of the inferior vena cava and the foramen ovale(the inner angle formed by the line connecting the opening of the foramen ovale on the left atrial side and the opening on the right atrial side and the axis of the inferior vena cava).Results:Compared with the asymptomatic PFO group,in the symptomatic PFO group during the Valsalva maneuver,the flow velocity at the entrance of the inferior vena cava was faster,the distance from the inferior vena cava to the foramen ovale was smaller,and the angle between the inferior vena cava and the foramen ovale was smaller,and the differences were statistically significant(P＜0.05).There were no statistically significant differences in the blood flow parameters of the inferior vena cava between the two groups at rest(P＞0.05);Spearman test showed that the flow velocity of the inferior vena cava during the Valsalva maneuver,the distance from the inferior vena cava to the foramen ovale,and the angle between the inferior vena cava and the foramen ovale were correlated with the clinical symptoms caused by PFO patients(r=0.323,-0.583,-0.747,all P＜0.05);the variables with statistically significant differences in the univariate analysis were used as independent variables,and PFO patients with or without relevant clinical symptom events were set as dependent variables,and multivariate binary Logistic regression analysis was performed.The results showed that the distance from the inferior vena cava to the foramen ovale during the Valsalva maneuver(OR=3.048,95%CI:1.902-4.886,P＜0.001)and the angle between the inferior vena cava and the foramen ovale(OR=1.680,95%CI:1.391-2.030,P＜0.001)could be used as independent predictors for whether PFO patients were complicated with clinical symptoms.Conclusion:The blood flow parameters of the inferior vena cava are related to the related clinical symptoms caused by PFO.After the inferior vena cava hemodynamic parameters change,hemodynamics also change accordingly,which may increase the possibility of thrombositis in situ within the PFO and cause related clinical symptoms after detachment.