{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:40:22Z","timestamp":1785393622825,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T00:00:00Z","timestamp":1607904000000},"content-version":"vor","delay-in-days":348,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81730050"],"award-info":[{"award-number":["81730050"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p><jats:italic>Purpose<\/jats:italic>. To analyze the characteristics of right\u2010to\u2010left shunt (RLS) in patients with cryptogenic stroke and migraine by contrast\u2010enhanced transesophageal echocardiography (c\u2010TEE). <jats:italic>Methods<\/jats:italic>. The study population consisted of 330 patients with cryptogenic stroke and 330 patients with migraine who suspected PFO. All of them received c\u2010TEE examination successfully. In terms of c\u2010TEE analyses, RLS could be diagnosed when microbubbles were visualized in the transition from the right atrium to the left atrium. For semiquantitative analysis, a small amount of RLS was grade 1, indicating 1\u201010 microvesicles per frame could be seen in the left atrium, a moderate amount of RLS was grade 2, indicating 11\u201030 microvesicles per frame could be seen in the left atrium, and a large amount of RLS was grade 3, indicating more than 30 microvesicles per frame, or the left atrium is filled with microvesicles. <jats:italic>Results<\/jats:italic>. A total of 660 patients were analyzed in the study. PFO\u2010RLS was detected in 348 (348\/660, 52.7%) cases by TEE, while in 392 (392\/660, 59.3%) cases by c\u2010TEE. Simultaneously, P\u2010RLS was detected in 239 (239\/660, 36.2%) cases by c\u2010TEE. Among 330 patients with cryptogenic stroke, PFO\u2010RLS was detected in 198 cases; according to the c\u2010TTE method (198\/330, 60.0%), concurrently, 83 participants suffered from PFO\u2010RLS and P\u2010RSL (83\/330, 25.1%), including 1 case with PFO and pulmonary arteriovenous fistula. Among 330 patients with migraine, PFO\u2010RLS was detected in 194 cases; according to the c\u2010TTE method (194\/330, 58.7%), specifically, 90 participants suffered from PFO\u2010RLS and P\u2010RSL (90\/330, 27.2%). There was no statistical significance between the two groups. P\u2010RLS singly was detected in 28 cases with cryptogenic stroke, while in 38 cases with migraine, excluding from pulmonary arteriovenous fistula by CTA examination. In addition, semiquantitative results on c\u2010TTE grading of RLS were compared between the two groups: grade 1 RLS in the migraine group (144\/322) was significantly higher than that in the cryptogenic stroke group (71\/309) (<jats:italic>P<\/jats:italic> &lt; 0.05). Grade 3 RLS in the cryptogenic stroke group (113\/309) was significantly higher than that in the migraine group (67\/322) (<jats:italic>P<\/jats:italic> &lt; 0.05). For grade 2 RLS, there was no statistical difference between the two groups (<jats:italic>P<\/jats:italic> = 0.12). <jats:italic>Conclusions<\/jats:italic>. c\u2010TEE can increase the positive rate of PFO diagnosis compared with TEE color Doppler. There is no significant difference in the incidence of PFO\u2010PLS and P\u2010RLS between the cryptogenic stroke group and the migraine group. The grades 2\u20103 RLS are mainly detected in the cryptogenic stroke group, while grades 1\u20102 RLS are mostly detected in the migraine group.<\/jats:p>","DOI":"10.1155\/2020\/8845652","type":"journal-article","created":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T19:35:08Z","timestamp":1607974508000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The Value of Contrast\u2010Enhanced Transesophageal Echocardiography in the Detection of Cardiac Right\u2010to\u2010Left Shunt Related with Cryptogenic Stroke and 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