Related Experiment Video
Updated: Jan 31, 2026

Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
Elevated left ventricular end-diastolic pressure favours closure of foramen ovale
Federico Landeta1, Elmar von dem Bussche, Martin Ritter
1Department of Cardiology and Angiology, University Hospital Muenster, Germany. flandeta@yahoo.com.ar
Insights
Persistent high left atrial pressures, not age, may influence patent foramen ovale (PFO) closure. Elevated left ventricular end-diastolic pressures (LVEDP) were linked to a lower PFO prevalence in patients with suspected cardioembolic stroke.
Area of Science:
- Cardiology
- Cardiovascular Research
- Medical Diagnostics
Background:
- Patent foramen ovale (PFO) is a common cardiac anomaly.
- Previous studies suggested PFO prevalence decreases with age.
- The relationship between left atrial pressure and PFO closure requires further investigation.
Purpose of the Study:
- To test the hypothesis that elevated left atrial (LA) pressures facilitate PFO closure.
- To investigate the role of age in PFO prevalence.
- To identify factors associated with PFO in patients with suspected cardioembolic stroke.
Main Methods:
- Contrast transesophageal echocardiography was used to assess PFO prevalence in 201 patients.
- Non-invasive transthoracic echocardiography estimated left ventricular end-diastolic pressures (LVEDP).
- Diastolic function (DF) and diastolic dysfunction (DD) stages were used to categorize LVEDP as normal or elevated.
Main Results:
- PFO prevalence was 42.8% overall.
- Patients with elevated LVEDP (DD stage II/III) had significantly lower PFO prevalence (21.2%) compared to those with normal LVEDP (51.7%).
- LA size was larger in patients without PFO, and age was not associated with PFO prevalence.
Conclusions:
- Elevated LVEDP and LA enlargement are negatively associated with PFO.
- Higher LVEDP correlates with a lower prevalence of PFO.
- Age does not play a significant role in PFO prevalence.
Objective:
It has been described that prevalence of patent foramen ovale (PFO) declines with age. Our hypothesis was that persistent high pressures in the left atria (LA), may facilitate closure of PFO and age would not play a role.
Methods And Results:
The prevalence of PFO was studied in 201 consecutive patients with suspicion of cardioembolic stroke by contrast transoesophageal echocardiography. Left ventricular end-diastolic pressures (LVEDP) were estimated non-invasively by transthoracic echocardiography. Patients with normal diastolic function (DF) or with diastolic dysfunction (DD) stage I were considered as having normal LVEDP whereas patients with DD stage II or III as having elevated LVEDP. Prevalence of PFO was 42.8% and it was smaller in patients with elevated LVEDP than in patients with normal LVEDP (21.2% vs. 51.7%, P < 0.01). There was a smaller prevalence of PFO in patients with DD stage II than in patients with DD stage I or normal DF (25% vs. 51 and 54%, both P < 0.05). Size of the LA was larger in patients without PFO [34.73 ml/m2 (24.14-40.84ml/m2) vs. 27.86 ml/m2 (21.37-34.68 ml/m2), P < 0.05]. Mean age was 64.2 years (57.38-75.77) with no difference between patients with PFO and without PFO. In multivariate analysis Eustachian valve, atrial septal aneurysm, elevated LVEDP and large LA remained significantly associated (P < 0.05) with PFO.
Conclusion:
Elevated LVEDP and enlargement of LA are negatively associated with PFO. The higher the LVEDP, the lower the prevalence of PFO. Age is not associated with PFO.
Related Concept Videos
Elevation of Intermediate Points on Vertical Curves
Freezing Point Depression and Boiling Point Elevation
The boiling point of a liquid is the temperature at which its vapor pressure is equal to ambient atmospheric pressure. Since the vapor pressure of a solution is lowered due to the presence of nonvolatile solutes, it stands to reason that the solution’s boiling point will subsequently be increased. Vapor pressure increases with temperature, and so a solution will require a higher temperature than will pure solvent to achieve any given vapor pressure, including one...
Gibbs Free Energy and Thermodynamic Favorability
Definition and Measurement of Pressure: Atmospheric Pressure, Barometer, and Manometer
Angle Closure Glaucoma: Treatment
Vapor Pressure

