Abstract
Objective: Percutaneous closure of patent foramen ovale (PFO) has been associated with improvement of migraine headache. Tissues-borne serotonin bypassing the metabolic active pulmonary circulation through the PFO is the proposed trigger of migraine attacks in susceptible patients.
Therefore a hypothetical decrease of arterial serotonin levels after PFO closure might explain the migraine improvement. Aim of the study: Aim of the study was the investigation of suitability of direct serotonin assay in venous and arterial blood in patients undergoing percutaneous PFO closure for further studying the mechanism of migraine improvement after PFO closure.
Materials and methods: Arterial and venous serum serotonin levels were investigated in eight patients undergoing correctional surgery operation. The samples were collected as follows: Venous and arterial blood before operation, arterial blood during operation, venous sample from right atrial central catheter and then peripheral venous and arterial sample 24 hours after the operation.
Serotonin levels were investigated in control group of 6 healthy patients. Serotonin was measured by commercially available enzyme immunoassay (EIA, Immunotech).
Results: The results (mean +- SD) were as follows: Control group: 906.0 +- 229.4 nmol/l, Venous blood before the operation: 126.0 +- 69.6 nmol/l, venous blood after the operation: 140 +- 40 nmol/l, arterial blood before the operation: 165+- 25 nmol/l, arterial blood during operation: 182 +- 44 nmol/l, arterial blood after the operation: 130 +- 36 nmol/l. Conclusion: Direct assay of serotonin with commercially available EIA is suitable for studying changes of serotonin levels after PFO closure.
Our preliminary results support the theory of the decrease of arterial blood levels of serotonin after PFO closure.