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Serotonin as a potential marker of endothelial dysfunction for cerebral embolism in patients with persistent foramen
Michał Tworek1, Weronika Włoczyk2, Anna Łukomska1
1Jagiellonian University Medical College, Faculty of Medicine, Institute of Cardiology, Department of Cardiac and Vascular Diseases, John Paul II Hospital, Krakow, Poland.
Introduction:
A persistent patent foramen ovale (PFO) is a congenital heart defect that predisposes to crossed embolism resulting in stroke. The defect can be accompanied by endothelial dysfunction. One marker reflecting endothelial dysfunction is serotonin, the concentration of which can be increased by passing through the PFO, thus bypassing degradation in the lungs.
Aim:
To study the potential association between endothelial dysfunction and the occurrence of cryptogenic stroke in patients with PFO, compared with patients without PFO and without a history of cryptogenic stroke.
Material And Methods:
Seventy-nine patients were recruited, including 51 (64.65%) women and 28 (35.44%) men, who underwent PFO closure surgery within the Clinical Department of Cardiovascular Diseases of the John Paul II Specialized Hospital of Krakow, Poland, for a history of cryptogenic stroke between 2009 and 2021. The mean age was 48.34 ±13.13 years. The control group consisted of 79 patients (male and female) without a stroke history. Patients underwent the following examinations: subject and physical examination, transthoracic and transesophageal echocardiography, and laboratory tests including serotonin levels collected before the PFO closure procedure.
Results:
There was a statistically significant difference between serotonin levels in the study group and the control group (1645.55 ±801.26 vs. 856.98 ±781.63; p < 0.001). There was no correlation between serotonin concentration and channel length and width (r = 0.082; p = 0.471; r = 0.085; p = 0.455).
Conclusions:
Serotonin levels appear to be significantly higher in patients with PFO after cryptogenic stroke compared with patients without PFO and stroke history. The length and width of the PFO canal may not correlate with serotonin levels.
