Is patent foramen ovale a family trait? A transcranial Doppler sonographicstudy

Background and Purpose-Patent foramen ovale (PFO) is a frequent finding in young patients with stroke. The aim of this study was to assess whether PFO is a family trait. Methods-Sixty-two consecutive patients younger than 60 years of age with is chemic stroke and 62 age and gender-matched control siblings were examined by means of contrast transcranial Doppler (TCD) of the middle cerebral arte ry, using a standardized protocol. The reliability of TCD examination in ou r laboratory was assessed against transesophageal echocardiography (TEE). A ll TCD recordings were reviewed by a blinded experienced observer from anot her center. Disagreements between readers were resolved by unblinded consen sus review. Results-Siblings of patients with PFO had a significantly higher prevalence of PFO than had siblings of patients without PFO (61.5% versus 30.6%; OR 3 .64 [1.3 to 10.5]; P=0.015). The K statistics indicated that agreement of p airs (patients/control siblings) was not due to chance. The strength of the association was sex dependent. In women pairs, prevalence of a PFO was 76. 5% in siblings of patients with PFO and 25% in siblings of patients without PFO, giving an OR of 9.8 (95% CI 2 to 47.9; P <0.01). In contrast, in men, no significant difference was observed in the prevalence of PFO between si blings of patients with or without PFO (respectively 33.3% and 35%), giving an OR of 0.9 (95% CI 0.2 to 4.9; P=0.9), Conclusions-This study suggests that, in women, PFO is a family trait.