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{{DISPLAYTITLE:Patent Foramen Ovale: The Unresolved Questions}}
{{DISPLAYTITLE:Patent Foramen Ovale: The Unresolved Questions}}
{{#seo:
{{#seo:
|title=The “Black Swan Principle” and the Genetics of Complex Diseases - Top Italian Scientists Journal
|title=Patent Foramen Ovale: The Unresolved Questions - Top Italian Scientists Journal
|description=The black swan principle is a philosophy theory created by Nassim Nicholas Taleb that seeks to explain rare and unpredictable events, appearances that seem to defy logic or rational explanation.
|description=Patent Foramen Ovale (PFO) is a remnant of fetal circulation that could be observed in the 25% of the population worldwide.
|keywords=Black Swan Principle; Genetics of Complex Diseases
|keywords=Cardiology; Migraine; Patent Foramen Ovale (PFO); Platypnea-orthodeoxia syndrome; Stroke; TIA;
|citation_author=Novelli, Giuseppe; Reichardt, Juergen K V
|citation_author=Forzano, Imma; Santulli, Gaetano
|citation_journal_title=Top Italian Scientists Journal  
|citation_journal_title=Top Italian Scientists Journal  
|citation_publication_date=2024/01/13
|citation_publication_date=2024/03/05
|citation_title=The “Black Swan Principle” and the Genetics of Complex Diseases
|citation_title=Patent Foramen Ovale: The Unresolved Questions
|citation_keywords=Black Swan Principle; Genetics of Complex Diseases
|citation_keywords=Cardiology; Migraine; Patent Foramen Ovale (PFO); Platypnea-orthodeoxia syndrome; Stroke; TIA;
|citation_publisher=Top Italian Scientists
|citation_publisher=Top Italian Scientists
|citation_volume=1
|citation_volume=1
|citation_issue=1
|citation_issue=2
|citation_pdf_url=https://journal.topitalianscientists.org/images/5/53/The_Black_Swan_Principle_and_the_Genetics_of_Complex_Diseases.pdf
|citation_doi=10.62684/DMFZ6956
|citation_abstract_html_url=https://journal.topitalianscientists.org/The_Black_Swan_Principle_and_the_Genetics_of_Complex_Diseases
|citation_doi=-
|citation_issn=3033-5132
|citation_issn=3033-5132
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| '''Published'''
| '''Published'''
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| January 13, 2024
| March 5, 2024
|-
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| '''Title'''  
| '''Title'''  
|-
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| style="width:200px;" | The “Black Swan Principle” and the Genetics of Complex Diseases
| style="width:200px;" | Patent Foramen Ovale: The Unresolved Questions
|-  
|-  
| '''Authors'''
| '''Authors'''
|-
|-
|  Giuseppe Novelli, Juergen K V Reichardt
|  Imma Forzano, Gaetano Santulli
|-
| '''DOI'''
|-
| [https://doi.org/10.62684/DMFZ6956 10.62684/DMFZ6956]
|-
|-
| '''Keywords'''
| '''Keywords'''
|-
|-
| Black Swan Principle; Genetics of Complex Diseases
| Cardiology; Migraine; Patent Foramen Ovale (PFO); Platypnea-orthodeoxia syndrome; Stroke; TIA;
|-
|-
| '''Downloads'''
| '''Downloads'''
|-
|-
|  style="text-align: center;" | [[File:PDF_file_icon.png|center|50px|'''Download PDF'''|link=https://journal.topitalianscientists.org/images/5/53/The_Black_Swan_Principle_and_the_Genetics_of_Complex_Diseases.pdf]]
|  style="text-align: center;" | [[File:PDF_file_icon.png|center|50px|'''Download PDF'''|link=https://journal.topitalianscientists.org/images/1/13/Patent_Foramen_Ovale_The_Unresolved_Questions.pdf]]
|}
|}
'''[https://topitalianscientists.org/tis/2359/Giuseppe_Novelli_-_Top_Italian_Scientist_in_Biomedical_Sciences Giuseppe Novelli]'''<sup>(a)</sup>, '''Juergen K V Reichardt'''<sup>(b)</sup>
'''Imma Forzano'''<sup>(a)</sup>, '''[https://topitalianscientists.org/tis/26943/Gaetano_Santulli_-_Top_Italian_Scientist_in_Biomedical_Sciences Gaetano Santulli]'''<sup>(a,b)</sup>


<sup>(a)</sup>Department of Biomedicine and Prevention, School of Medicine and Surgery, Tor Vergata University of Rome, Via Montpellier 1, 00133, Rome, Italy and Department of Pharmacology, School of Medicine, University of Nevada, 89557, Reno, NV, USA.
<sup>(a)</sup> Department of Advanced Biomedical Sciences, Division of Cardiology, “Federico II” University, International Translational Research and Medical Education (ITME) Consortium, Academic Research Unit, 80131, Naples, Italy;


<sup>(b)</sup>Australian Institute of Tropical Health and Medicine, James Cook University, Smithfield, QLD, 4878, Australia.
<sup>(b)</sup> Department of Medicine (Division of Cardiology), Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York City, 10461, NY.


''Correspondence to'': novelli@med.uniroma2.it
''Correspondence to'': Department of Medicine (Division of Cardiology), Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York City, 10461, NY. gsantulli001@gmail.com


==Abstract==
==Abstract==
The black swan principle is a philosophy theory created by Nassim Nicholas Taleb that seeks to explain rare and unpredictable events, appearances that seem to defy logic or rational explanation. These events, termed "Black Swans," have been observed in various domains, including finance, public administration, infectious diseases, and ecology. The concept of Black Swans has gained recently, significant attention in academia and practice due to its relevance in understanding extreme and rare occurrences. The “black swan” concept has been used in genetics for the unexpected developments that genome sequencing would reveal and which could have consequences for healthcare systems (e.g., increase in often unnecessary and inappropriate diagnostic investigations, increase in non-patients, etc.).
Patent Foramen Ovale (PFO) is a remnant of fetal circulation that could be observed in the 25% of the population worldwide. PFO is associated to numerous clinical conditions as migraines, coronary embolization, transient ischemic attacks, and stroke. The main PFO concerns are related to its correlation to stroke, in particular in young adults. Despite the impact on morbidity that PFO could have, to date there is not clear evidence about its management and treatment. In this narrative review our aim is to summarize the more recent evidence in the literature dealing with PFO, in order to provide an updated overview on this topic.
 
==Declarations==
===Conflict of Interest===
The Authors declare that there is no conflict of interest.
 
===Funding===
The Santulli’s Lab is currently supported in part by the National Institutes of Health (NIH): National Heart, Lung, and Blood Institute (NHLBI: R01-HL164772, R01-HL159062, R01-HL146691, T32-HL144456), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK: R01-DK123259, R01-DK033823), National Center for Advancing Translational Sciences (NCATS: UL1-TR002556-06, UM1-TR004400) to G.S., by the Diabetes Action Research and Education Foundation (to G.S.), by the Waxman Research Foundation (to G.S.), and by the Monique Weill-Caulier and Irma T. Hirschl Trusts (to G.S.).


==References==
<ol class="references">
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<li>Khessali H, Mojadidi MK, Gevorgyan R, Levinson R, Tobis J: The effect of patent foramen ovale closure on visual aura without headache or typical aura with migraine headache. JACC Cardiovasc Interv 2012, 5(6):682-687.</li>
<li>Papa M, Gaspardone A, Fragasso G, Ajello S, Gioffre G, Iamele M, Iani C, Margonato A: Usefulness of transcatheter patent foramen ovale closure in migraineurs with moderate to large right-to-left shunt and instrumental evidence of cerebrovascular damage. Am J Cardiol 2009, 104(3):434-439.</li>
<li>Wahl A, Praz F, Tai T, Findling O, Walpoth N, Nedeltchev K, Schwerzmann M, Windecker S, Mattle HP, Meier B: Improvement of migraine headaches after percutaneous closure of patent foramen ovale for secondary prevention of paradoxical embolism. Heart 2010, 96(12):967-973.</li>
<li>Trabattoni D, Brambilla M, Canzano P, Becchetti A, Teruzzi G, Porro B, Fiorelli S, Muratori M, Tedesco CC, Veglia F et al: Migraine in Patients Undergoing PFO Closure: Characterization of a Platelet-Associated Pathophysiological Mechanism: The LEARNER Study. JACC Basic Transl Sci 2022, 7(6):525-540.</li>
<li>Sommer RJ, Nazif T, Privitera L, Robbins BT: Retrospective review of thienopyridine therapy in migraineurs with patent foramen ovale. Neurology 2018, 91(22):1002-1009.</li>
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<li>Schwerzmann M, Seiler C, Lipp E, Guzman R, Lovblad KO, Kraus M, Kucher N: Relation between directly detected patent foramen ovale and ischemic brain lesions in sport divers. Ann Intern Med 2001, 134(1):21-24.</li>
<li>Honek J, Sramek M, Sefc L, Januska J, Fiedler J, Horvath M, Tomek A, Novotny S, Honek T, Veselka J: High-grade patent foramen ovale is a risk factor of unprovoked decompression sickness in recreational divers. J Cardiol 2019, 74(6):519-523.</li>
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<li>Kent DM, Saver JL, Kasner SE, Nelson J, Carroll JD, Chatellier G, Derumeaux G, Furlan AJ, Herrmann HC, Juni P et al: Heterogeneity of Treatment Effects in an Analysis of Pooled Individual Patient Data From Randomized Trials of Device Closure of Patent Foramen Ovale After Stroke. JAMA 2021, 326(22):2277-2286.</li>
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<li>Onorato EM, Grancini L, Monizzi G, Mastrangelo A, Fabbiocchi F, Bartorelli AL: Noblestitch(R) system for PFO closure: A novel but judicious alternative to traditional devices-A case report. Front Cardiovasc Med 2023, 10:1095661.</li>
</ol>


[[Category:Open Access]]
[[Category:Open Access]]

Latest revision as of 12:29, 24 March 2024

Published
March 5, 2024
Title
Patent Foramen Ovale: The Unresolved Questions
Authors
Imma Forzano, Gaetano Santulli
DOI
10.62684/DMFZ6956
Keywords
Cardiology; Migraine; Patent Foramen Ovale (PFO); Platypnea-orthodeoxia syndrome; Stroke; TIA;
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Download PDF
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Imma Forzano(a), Gaetano Santulli(a,b)

(a) Department of Advanced Biomedical Sciences, Division of Cardiology, “Federico II” University, International Translational Research and Medical Education (ITME) Consortium, Academic Research Unit, 80131, Naples, Italy;

(b) Department of Medicine (Division of Cardiology), Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York City, 10461, NY.

Correspondence to: Department of Medicine (Division of Cardiology), Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York City, 10461, NY. gsantulli001@gmail.com

Abstract

Patent Foramen Ovale (PFO) is a remnant of fetal circulation that could be observed in the 25% of the population worldwide. PFO is associated to numerous clinical conditions as migraines, coronary embolization, transient ischemic attacks, and stroke. The main PFO concerns are related to its correlation to stroke, in particular in young adults. Despite the impact on morbidity that PFO could have, to date there is not clear evidence about its management and treatment. In this narrative review our aim is to summarize the more recent evidence in the literature dealing with PFO, in order to provide an updated overview on this topic.

Declarations

Conflict of Interest

The Authors declare that there is no conflict of interest.

Funding

The Santulli’s Lab is currently supported in part by the National Institutes of Health (NIH): National Heart, Lung, and Blood Institute (NHLBI: R01-HL164772, R01-HL159062, R01-HL146691, T32-HL144456), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK: R01-DK123259, R01-DK033823), National Center for Advancing Translational Sciences (NCATS: UL1-TR002556-06, UM1-TR004400) to G.S., by the Diabetes Action Research and Education Foundation (to G.S.), by the Waxman Research Foundation (to G.S.), and by the Monique Weill-Caulier and Irma T. Hirschl Trusts (to G.S.).

References

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