Ischemic cerebrovascular disease caused by genetic mutation and patent foramen ovale

Esra Eruyar, Tevfik Honca, Fatih Bakır
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Abstract

Abstract Objectives The search for genetic mutations is very important in younger patients and other age groups with a history of recurrent cerebrovascular diseases (CVD) and a family history of other causes to be excluded. The aim of this study is to define the characteristics of genetic mutations in the etiology of ischemic stroke. Methods Twenty-three patients with acute CVD in the last 1 year and only genetic mutations acknowledged in the etiology were retrospectively analyzed. We determined the frequency of the genetic mutations that are observed in cerebral arterial events (CAE) and cerebral venous thrombosis (CVT). Results All patients had at least one genetic mutation and 19 of them had arterial events and 4 had venous thrombosis. MTHFR mutation was the most common mutation and PAI-1 mutation was the second in line for the arterial events. PAI 4G/5G, MTHFR A1298 and FV mutations were most frequently observed in venous events. Patent foramen ovale (PFO) was detected in 14 patients (%74) with CAE. Conclusions We concluded that multiple gene mutations may significantly increase the development of CVD. CVD is most commonly associated with MTHFR, PAI-1 or FV gene mutations and is most commonly seen in CAE. MTHFR mutations showed moderate linear correlation in the development of arterial events and FXII and FXIII mutations in venous events. The association of thrombophilia and PFO is high in patients who have undergone CAE, especially responsible for recurrent events. This study will need to be confirmed by prospective studies with larger sample and control group.
基因突变和卵圆孔未闭引起的缺血性脑血管病
【摘要】目的寻找基因突变对于年轻患者和其他有复发性脑血管病(CVD)病史且家族史排除其他原因的年龄组非常重要。本研究的目的是确定缺血性脑卒中病因的基因突变特征。方法回顾性分析近1年来23例病因为基因突变的急性心血管疾病患者的临床资料。我们确定了在脑动脉事件(CAE)和脑静脉血栓形成(CVT)中观察到的基因突变的频率。结果所有患者至少有1个基因突变,其中19例发生动脉事件,4例发生静脉血栓形成。MTHFR突变是最常见的突变,PAI-1突变是动脉事件的第二顺位突变。PAI 4G/5G、MTHFR A1298和FV突变在静脉事件中最常见。14例(%74)CAE患者发现卵圆孔未闭。结论多基因突变可能显著增加心血管疾病的发生。CVD最常与MTHFR、PAI-1或FV基因突变相关,最常见于CAE。MTHFR突变与动脉事件的发生呈中度线性相关,而FXII和FXIII突变与静脉事件的发生呈中度线性相关。血栓形成和PFO的相关性在CAE患者中很高,特别是对复发事件负责的患者。这项研究还需要通过更大样本和对照组的前瞻性研究来证实。
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