Patent Foramen Ovale Channel Morphometric Characteristics Associated with Cryptogenic Stroke: The MorPFO Score.

Area of Science:

• Cardiology
• Neurology
• Medical Imaging

Background:

• The link between patent foramen ovale (PFO) morphology and stroke occurrence remains debated.
• This study investigates morphometric and functional PFO channel differences in cryptogenic stroke patients versus controls.

Purpose of the Study:

• To evaluate morphometric and functional PFO channel features in patients with and without cryptogenic stroke.
• To identify specific PFO characteristics associated with stroke risk.

Main Methods:

• Transesophageal echocardiography (TEE) analyzed PFO channel morphology in 106 cryptogenic stroke patients and 93 controls.
• A validation cohort of 31 stroke patients and 30 controls was used.
• Multivariable regression logistic analyses identified stroke-related PFO factors.

Main Results:

• PFO channel length change, length/height ratio, septum primum thickness, septum secundum height, atrial septal aneurysm, and shunt size were significant stroke factors.
• The Morphologic Stroke Factors of PFO (MorPFO) score was developed, incorporating six key factors.
• The MorPFO score demonstrated strong performance in external validation (C-index = 0.90), categorizing PFO channels into low, intermediate, and high stroke risk.

Conclusions:

• Transesophageal echocardiography can differentiate pathogenic from incidental PFO channels based on morphology.
• The MorPFO score is a valuable tool for identifying PFO channels associated with a high risk of stroke.