Technological advancements in right heart acoustic angiography for predicting patent foramen ovale and its correlation with AIS: A retrospective study

Background Acute ischemic stroke (AIS) is a leading cause of disability and mortality worldwide, often resulting from embolic events. Patent foramen ovale (PFO), a common congenital heart defect, has been identified as a potential source of emboli in AIS patients, especially in cases of cryptogenic stroke where no other etiology is found. Objective This study aimed to investigate the relationship between AIS and PFO, and to explore the diagnostic value of right heart acoustic angiography for PFO. Methods A study included 148 AIS and 111 non-AIS patients with suspected PFO, using transesophageal echocardiography (TEE) as the diagnostic gold standard. Sensitivity, specificity, and accuracy of right heart acoustic angiography for PFO diagnosis were evaluated. ROC and Spearman correlation analyses assessed diagnostic value and the association between AIS and PFO. Results PFO was detected in 79 AIS patients and 20 non-AIS patients, with a higher detection rate in the AIS group ( P < 0.05). Right heart acoustic angiography showed a diagnostic accuracy of 95.37% for PFO, with a sensitivity of 95.37% and a specificity of 97.78%. The AUC value of the ROC curve for right heart acoustic imaging was 0.975, indicating high diagnostic efficacy for PFO. PFO was positively correlated with AIS (r = 0.318, P < 0.001). Conclusion PFO is commonly detected in AIS patients and is positively correlated with AIS. Right heart acoustic imaging has high diagnostic efficacy for PFO and can be a valuable diagnostic tool for patients with PFO.