翻译：静息时cTTE检测到右向左分流RLS的有 135例cTEE检测到RLS的有 140例。 Valsalva动作下cTTE检测到RLS的有 186例cTEE检测到RLS的有 186例提示Valsalva动作时无论cTTE还是cTEE方法的PFO-RLS检查率较静息状态下均有显著提升。在检出右向左分流的PFO患者cTTE中I级27 例;II级31例;III级128 例；cTEE中I级 80 例;

During rest, cTTE detected 135 cases of right to left shunting (RLS), while cTEE detected 140 cases of RLS. During the Valsalva maneuver, cTTE detected 186 cases of RLS, and cTEE also detected 186 cases of RLS, indicating a significant increase in the detection rate of PFO-RLS during the Valsalva maneuver compared to the rest state, regardless of the cTTE or cTEE method.

Among the patients with detected right to left shunting PFO, cTTE classified 27 cases as grade I, 31 cases as grade II, and 128 cases as grade III. On the other hand, cTEE classified 80 cases as grade I, 56 cases as grade II, and 50 cases as grade III. Among these cases, 107 patients had a higher RLS degree in cTTE compared to cTEE, with 46 cases being grade III in cTTE and grade II in cTEE, 43 cases being grade III in cTTE and grade I in cTEE, and 21 cases being grade II in cTTE and grade I in cTEE. 59 patients had the same degree of RLS detected in both cTTE and cTEE. Only 17 cases had a lower degree of RL shunting in cTTE compared to cTEE.

During the Valsalva maneuver with cTEE, while the operator clenched their fist and applied pressure on the patient's abdomen and then released it, 186 cases of RLS were detected. Among these, 35 cases were classified as grade I, 46 cases as grade II, and 105 cases as grade III. 76 patients had an increase in RLS grade, including 21 patients who upgraded from grade I to grade II, 24 patients who upgraded from grade I to grade III, and 31 patients who upgraded from grade II to grade III. The proportion of patients with moderate to large shunting significantly increased