{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:39:01Z","timestamp":1783035541698,"version":"3.54.6"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T00:00:00Z","timestamp":1730764800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We previously reported four patent foramen ovale (PFO) morphological types that influenced right\u2010to\u2010left shunt (RLS) grades. Herein, we aimed to study the relationship between PFO morphology and cryptogenic stroke (CS). We further developed a nomogram based on four PFO morphological types and functional parameters to guide clinicians in judging the risk of PFO\u2010associated stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective observational study involving adult patients with PFO between January 2020 and November 2022. Patients were divided into a PFO\u2010associated stroke group (CS group) and a group without cryptogenic stroke (non\u2010CS group). Four types of PFO and RLS grades were analyzed. Nomograms were made to predict PFO\u2010associated stroke using multivariable logistic regression analysis. The discrimination performance of the model was internally validated and assessed using the receiver operating characteristic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We enrolled 389 patients (male, 182 patients; female, 207 patients) with PFO, the mean age was 43.3\u00a0\u00b1\u00a08.1 years. The derivation cohort comprised 293 patients (CS group, 186 patients; non\u2010CS group, 107 patients). The predictive nomogram comprised PFO morphological types, interatrial septum (IAS) mobility distance, septum primum thickness, PFO channel length at rest, and contrast\u2010transthoracic echocardiography (c\u2010TTE) RLS grade during the Valsalva maneuver. A validation cohort was established (CS group, 61 patients; non\u2010CS group, 35 patients). The model area under the curve (AUC) was 0.891 (95% confidence interval = 0.855\u22120.928) in the derivation cohort and 0.935 (95% confidence interval = 0.885\u22120.986) in the validation cohort. Calibration curve analysis showed that the nomogram had a C\u2010index of 0.891 in the derivation cohort and 0.935 in the validation cohort. The decision curve analysis (DCA) indicated that the nomogram had clinical applicability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adding four PFO morphological types improved the risk stratification capability for PFO\u2010associated stroke. The nomogram can identify high or low\u2010risk PFO individuals and select patients who will likely benefit from interventional device closure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.15932","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T01:46:02Z","timestamp":1730857562000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Development and Validation of an Individualized Nomogram for Predicting Patent Foramen Ovale\u2010Associated Stroke: Patent Foramen Ovale Morphology\u2010Based Analysis"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5631-0137","authenticated-orcid":false,"given":"Qin","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Cardiology The Fifth Affiliated Hospital of Sun Yat\u2010Sen University  Zhuhai 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