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The Reply
We recently reported an updated meta-analysis of 5 published randomized clinical trials evaluating patent foramen ovale closure compared with medical therapy in patients with cryptogenic stroke.1 Drs. Shi and Tie2 offer alternative methodological approaches to pooling estimates of treatment effects and call for more detailed statistical accounting. We agree that appropriate and rigorous meta-analytic methods are important given the small number of observed events, differences in endpoint selection and definitions, and variable follow-up durations across selected trials.
Source: The American Journal of Medicine - May 19, 2018 Category: General Medicine Authors: Muthiah Vaduganathan, Arman Qamar, Ankur Gupta, Navkaranbir Bajaj, Harsh B. Golwala, Ambarish Pandey, Deepak L. Bhatt Tags: Letter Source Type: research

RoPES, Strokes and Closures
We read with great interest the review article by Dalen and Alpert regarding “Which Patent Foramen Ovales Need Closure to Prevent Cryptogenic Strokes?”1 The authors have provided a succinct contemporary review and have also distinctively tabulated the results of the path-defining trials in this somewhat contentious field. The main message provided by the authors is that in patients with cryptogenic stroke, a patent foramen ovale associated with an atrial septal aneurysm should be closed and that closure is not indicated when an atrial septal aneurysm is absent.
Source: The American Journal of Medicine - October 27, 2018 Category: General Medicine Authors: Adil S. Wani, Suhail Q. Allaqaband, M. Fuad Jan Tags: Letter Source Type: research

Echocardiographic Measures of Left Atrial Function and Size and Incident Dementia
To the Editor A recent study described a significant association between left atrial function and an increased risk of subsequent dementia, independent of the presence of atrial fibrillation. These findings are similar to our 2009 study, which examined subclinical left atrial dysfunction and risk of stroke in patients with patent foramen ovale (PFO). We found that impairment of reservoir, conduit, and contractile strain and impairment of emptying, passive emptying, and active emptying fraction was present in patients with multiple ischemic events, PFO, and atrial septal aneurysm compared with healthy individuals. After PFO...
Source: JAMA - July 19, 2022 Category: General Medicine Source Type: research

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