Association between patent foramen ovale and chronic obstructive pulmonary disease: A systematic review and meta-analysis

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart & Lung Pub Date : 2025-04-23 DOI:10.1016/j.hrtlng.2025.04.024

Sruthy Balakumar , Naya Nadeem , Areeba Asghar MSc , Claudia Frankfurter , Ashley Farrell MLIS, AHIP , Eduardo Flores-Umanzor MD, PhD , Eric Horlick MDCM , Lusine Abrahamyan MD, MPH, PhD

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引用次数: 0

Abstract

Background

Patent foramen ovale (PFO) is a defect in the intra-atrial septum that occurs when the foramen ovale does not close postnatally. Chronic obstructive pulmonary disease (COPD) is a respiratory condition that causes airflow obstruction.

Objective

This systematic review aimed to consolidate current evidence on the association between PFO and COPD outcomes.

Methods

We searched Medline, Embase, and Cochrane databases from inception to November 2023 for studies conducted among adults who have been diagnosed with COPD and underwent testing for PFO. A structured data extraction sheet was created to collect data from selected studies. A meta-analysis with a random effects model was considered when feasible.

Results

The initial search identified 765 records. After screening for eligibility, we included six cross-sectional and three case report studies. In cross-sectional studies, patients with COPD had almost three times higher odds of having PFO than controls (OR = 2.72, 95 % CI: 1.57 to 4.70, I² =0 %). When comparing COPD patients with and without PFO, the pooled mean difference was -2.99 mmHg; 95 % CI:5.55 to -0.44, I² =77 %) in oxygen saturation (SaO2), -6.85 mmHg (95 %CI:11.71 to -2.39, I² =35 %) in arterial oxygen partial pressure (PaO2) and 9.65 mmHg (95 %CI: 3.38 to 12.92, I² =0 %) in pulmonary arterial pressure.

Conclusions

Evidence, based on a few and small size studies, indicates that PFO presence may be associated with worse outcomes in COPD patients. The long-term impact of these findings on COPD outcomes and the need for identifying high-risk patients for PFO screening should be evaluated.

查看原文本刊更多论文

卵圆孔未闭与慢性阻塞性肺疾病的关系：一项系统综述和荟萃分析

背景先天性卵圆孔缺损（PFO）是指卵圆孔在出生后未闭合而导致的房间隔内缺陷。慢性阻塞性肺疾病（COPD）是一种导致气流阻塞的呼吸系统疾病。本系统综述旨在整合目前有关 PFO 与 COPD 结果之间关联的证据。我们制作了结构化数据提取表，以收集所选研究的数据。在可行的情况下，我们考虑采用随机效应模型进行荟萃分析。经过资格筛选，我们纳入了六项横断面研究和三项病例报告研究。在横断面研究中，慢性阻塞性肺病患者患有 PFO 的几率几乎是对照组的三倍（OR = 2.72，95 % CI：1.57 至 4.70，I2 = 0 %）。在比较有 PFO 和无 PFO 的慢性阻塞性肺病患者时，血氧饱和度（SaO2）的汇总平均差异为 -2.99 mmHg；95 % CI：5.55 至 -0.44，I2 =77 %），动脉氧分压（PaO2）的汇总平均差异为 -6.85 mmHg（95 %CI：11.71 至 -2.39，I2 =35 %），血氧饱和度（SaO2）的汇总平均差异为 9.结论基于少数小规模研究的证据表明，PFO 的存在可能与慢性阻塞性肺病患者较差的预后有关。应评估这些发现对慢性阻塞性肺病预后的长期影响，以及识别高危患者进行 PFO 筛查的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart & Lung 医学-呼吸系统

CiteScore

4.60

自引率

3.60%

发文量

184

审稿时长

35 days

期刊介绍： Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders. The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.