Correlations between left ventricular mass index and cerebrovascular lesion

• Authors: Kyusik Kang , Seung-Hoon Lee , Beom Kim , Jae-Sung Lim , Byung-Woo Yoon
• Languages of publication: EN

Abstracts

EN

Left ventricular (LV) mass and LV geometry are well-established measures of hypertension chronicity and severity, have a prognostic value on cardiovascular morbidity and mortality, and are related to asymptomatic cerebral small-artery disease (SAD) and largeartery disease (LAD). The aim of the present study was to clarify the different effects of LV mass and LV geometry on underlying SAD compared with its effects on underlying LAD in ischemic stroke patients. Four hundred three ischemic stroke patients underwent echocardiography to determine LV mass index and relative wall thickness. Brain magnetic resonance imaging, angiography, and carotid magnetic resonance angiography were preformed to detect LAD (≥50% stenosis) and SAD (leukoaraiosis, microbleeds, and old lacunar infarction) in the brain. Multivariate analyses showed that the LV mass index was highly associated with underlying SAD but not with underlying LAD. Among the various subtypes of SAD, only cerebral microbleeds were closely related to the LV mass index. Concentric LV hypertrophy was not related to the presence of either SAD or LAD. Subgroup analyses revealed that, among the various subtypes of SAD, only cerebral microbleeds were associated with concentric LV hypertrophy. In conclusion, cerebral microbleeds may imply more advanced target organ damage than underlying LAD and ischemic subtypes of SAD.

Keywords

EN

Left ventricular mass index; Left ventricular geometry; Left ventricular hypertrophy; Magnetic resonance imaging; Stroke; Echocardiography; Cerebral microbleeds

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2011
• Volume: 6
• Issue: 3
• Pages: 320-330

Dates

published

1 - 6 - 2011

online

8 - 4 - 2011

Contributors

author

Kyusik Kang

• Department of Neurology, Eulji General Hospital, 280-1 Hagye 1-dong, Nowon-gu, Seoul, 139-711, Republic of Korea

author

Seung-Hoon Lee

author

Beom Kim

author

Jae-Sung Lim

• Department of Neurology, Seoul National University Hospital, 28 Yeongeon-dong, Jongno-gu, Seoul, 110-744, Republic of Korea

author

Byung-Woo Yoon

References

• [1] Shigematsu Y., Hamada M., Mukai M., Matsuoka H., Sumimoto T., Hiwada K., Clinical evidence for an association between left ventricular geometric adaptation and extracardiac target organ damage in essential hypertension, J Hypertens, 1995, 13, 155–160 http://dx.doi.org/10.1097/00004872-199501000-00022[Crossref]
• [2] Rosand J., Hypertension and the brain: stroke is just the tip of the iceberg, Neurology, 2004, 63, 6–7 [Crossref]
• [3] Levy D., Garrison R. J., Savage D. D., Kannel W. B., Castelli W. P., Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study, N Engl J Med, 1990, 322, 1561–1566 http://dx.doi.org/10.1056/NEJM199005313222203[Crossref]
• [4] Koren M. J., Devereux R. B., Casale P. N., Savage D. D., Laragh J. H., Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension, Ann Intern Med, 1991, 114, 345–352 [Crossref]
• [5] Krumholz H. M., Larson M., Levy D., Prognosis of left ventricular geometric patterns in the Framingham Heart Study, J Am Coll Cardiol, 1995, 25, 879–884 http://dx.doi.org/10.1016/0735-1097(94)00473-4[Crossref]
• [6] Fox E. R., Alnabhan N., Penman A. D., Butler K. R., Taylor H. A., Jr., Skelton T. N., et al., Echocardiographic left ventricular mass index predicts incident stroke in African Americans: Atherosclerosis Risk in Communities (ARIC) Study, Stroke, 2007, 38, 2686–2691 http://dx.doi.org/10.1161/STROKEAHA.107.485425[Crossref][WoS]
• [7] Cuspidi C., Mancia G., Ambrosioni E., Pessina A., Trimarco B., Zanchetti A., Left ventricular and carotid structure in untreated, uncomplicated essential hypertension: results from the Assessment Prognostic Risk Observational Survey (APROS), J Hum Hypertens, 2004, 18, 891–896 http://dx.doi.org/10.1038/sj.jhh.1001759[Crossref]
• [8] Sierra C., de la Sierra A., Pare J. C., Gomez-Angelats E., Coca A., Correlation between silent cerebral white matter lesions and left ventricular mass and geometry in essential hypertension, Am J Hypertens, 2002, 15, 507–512 http://dx.doi.org/10.1016/S0895-7061(02)02277-X[Crossref]
• [9] Lee S. H., Park J. M., Kwon S. J., Kim H., Kim Y. H., Roh J. K., et al., Left ventricular hypertrophy is associated with cerebral microbleeds in hypertensive patients, Neurology, 2004, 63, 16–21 [Crossref]
• [10] Kohara K., Zhao B., Jiang Y., Takata Y., Fukuoka T., Igase M., et al., Relation of left ventricular hypertrophy and geometry to asymptomatic cerebrovascular damage in essential hypertension, Am J Cardiol, 1999, 83, 367–370 http://dx.doi.org/10.1016/S0002-9149(98)00870-4[Crossref]
• [11] Kohara K., Igase M., Yinong J., Fukuoka T., Maguchi M., Okura T., et al., Asymptomatic cerebrovascular damages in essential hypertension in the elderly, Am J Hypertens, 1997, 10, 829–835 http://dx.doi.org/10.1016/S0895-7061(97)00116-7[Crossref]
• [12] Gullu H., Erdogan D., Caliskan M., Tok D., Yildirim E., Ulus T., et al., Interrelationship between noninvasive predictors of atherosclerosis: transthoracic coronary flow reserve, flow-mediated dilation, carotid intima-media thickness, aortic stiffness, aortic distensibility, elastic modulus, and brachial artery diameter, Echocardiography, 2006, 23, 835–842 http://dx.doi.org/10.1111/j.1540-8175.2006.00342.x[Crossref]
• [13] Roman M. J., Saba P. S., Pini R., Spitzer M., Pickering T. G., Rosen S., et al., Parallel cardiac and vascular adaptation in hypertension, Circulation, 1992, 86, 1909–1918 [Crossref]
• [14] Takiuchi S., Kamide K., Miwa Y., Tomiyama M., Yoshii M., Matayoshi T., et al., Diagnostic value of carotid intima-media thickness and plaque score for predicting target organ damage in patients with essential hypertension, J Hum Hypertens, 2004, 18, 17–23 http://dx.doi.org/10.1038/sj.jhh.1001628[Crossref]
• [15] Roman M. J., Pickering T. G., Schwartz J. E., Pini R., Devereux R. B., Association of carotid atherosclerosis and left ventricular hypertrophy, J Am Coll Cardiol, 1995, 25, 83–90 http://dx.doi.org/10.1016/0735-1097(94)00316-I[Crossref]
• [16] Roman M. J., Pickering T. G., Pini R., Schwartz J. E., Devereux R. B., Prevalence and determinants of cardiac and vascular hypertrophy in hypertension, Hypertension, 1995, 26, 369–373 [Crossref]
• [17] Muiesan M. L., Pasini G., Salvetti M., Calebich S., Zulli R., Castellano M., et al., Cardiac and vascular structural changes. Prevalence and relation to ambulatory blood pressure in a middle-aged general population in northern Italy: the Vobarno Study, Hypertension, 1996, 27, 1046–1052 [Crossref]
• [18] Hughes A. D., Sinclair A. M., Geroulakos G., Mayet J., Mackay J., Shahi M., et al., Structural changes in the heart and carotid arteries associated with hypertension in humans, J Hum Hypertens, 1993, 7, 395–397
• [19] Ganau A., Devereux R. B., Roman M. J., de Simone G., Pickering T. G., Saba P. S., et al., Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension, J Am Coll Cardiol, 1992, 19, 1550–1558 http://dx.doi.org/10.1016/0735-1097(92)90617-V[Crossref]
• [20] Selvetella G., Notte A., Maffei A., Calistri V., Scamardella V., Frati G., et al., Left ventricular hypertrophy is associated with asymptomatic cerebral damage in hypertensive patients, Stroke, 2003, 34, 1766–1770 http://dx.doi.org/10.1161/01.STR.0000078310.98444.1D[Crossref]
• [21] Kim B. J., Lee S. H., Kang B. S., Yoon B. W., Roh J. K., Diabetes increases large artery diseases, but not small artery diseases in the brain, J Neurol, 2008, 255, 1176–1181 http://dx.doi.org/10.1007/s00415-008-0864-0[Crossref][WoS]
• [22] Adams H. P., Jr., Bendixen B. H., Kappelle L. J., Biller J., Love B. B., Gordon D. L., et al., Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment, Stroke, 1993, 24, 35–41
• [23] Devereux R. B., Reichek N., Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method, Circulation, 1977, 55, 613–618 [Crossref]
• [24] Devereux R. B., Lutas E. M., Casale P. N., Kligfield P., Eisenberg R. R., Hammond I. W., et al., Standardization of M-mode echocardiographic left ventricular anatomic measurements, J Am Coll Cardiol, 1984, 4, 1222–1230 http://dx.doi.org/10.1016/S0735-1097(84)80141-2[Crossref]
• [25] Reichek N., Devereux R. B., Reliable estimation of peak left ventricular systolic pressure by M-mode echographic-determined end-diastolic relative wall thickness: identification of severe valvular aortic stenosis in adult patients, Am Heart J, 1982, 103, 202–203 http://dx.doi.org/10.1016/0002-8703(82)90493-8[Crossref]
• [26] Kang K., Lee S. H., Yoon B. W., Basilar artery stenoocclusive disease is associated with structural changes in the left ventricle, Acta Cardiol, 2009, 64, 493–498 http://dx.doi.org/10.2143/AC.64.4.2041614[Crossref][WoS]
• [27] Kang K., Lee Y. S., Kim N. H., Kim D. E., Park S. H., Associated ischemic lesions in intracranial hemorrhage: MRI study, Eur Neurol, 2003, 49, 94–97 http://dx.doi.org/10.1159/000068507[Crossref]
• [28] Fazekas F., Chawluk J. B., Alavi A., Hurtig H. I., Zimmerman R. A., MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging, AJR Am J Roentgenol, 1987, 149, 351–356 [Crossref]
• [29] de Jong G., Kessels F., Lodder J., Two types of lacunar infarcts: further arguments from a study on prognosis, Stroke, 2002, 33, 2072–2076 http://dx.doi.org/10.1161/01.STR.0000022807.06923.A3[Crossref]
• [30] Masugata H., Senda S., Goda F., Yamagami A., Okuyama H., Kohno T., et al., Differences in left ventricular hypertrophy and dysfunction between patients with cerebral hemorrhage and those with cerebral infarction, Tohoku J Exp Med, 2008, 215, 159–165 http://dx.doi.org/10.1620/tjem.215.159[Crossref]
• [31] Di Tullio M. R., Zwas D. R., Sacco R. L., Sciacca R. R., Homma S., Left ventricular mass and geometry and the risk of ischemic stroke, Stroke, 2003, 34, 2380–2384 http://dx.doi.org/10.1161/01.STR.0000089680.77236.60[Crossref]
• [32] Shigematsu Y., Hamada M., Ohtsuka T., Hashida H., Ikeda S., Kuwahara T., et al., Left ventricular geometry as an independent predictor for extracardiac target organ damage in essential hypertension, Am J Hypertens, 1998, 11, 1171–1177 http://dx.doi.org/10.1016/S0895-7061(98)00140-X[Crossref]
• [33] Cordonnier C., Al-Shahi Salman R., Wardlaw J., Spontaneous brain microbleeds: systematic review, subgroup analyses and standards for study design and reporting, Brain, 2007, 130, 1988–2003 http://dx.doi.org/10.1093/brain/awl387[WoS][Crossref]
• [34] Viswanathan A., Chabriat H., Cerebral microhemorrhage, Stroke, 2006, 37, 550–555 http://dx.doi.org/10.1161/01.STR.0000199847.96188.12[Crossref]
• [35] Vernooij M. W., Haag M. D., van der Lugt A., Hofman A., Krestin G. P., Stricker B. H., et al., Use of antithrombotic drugs and the presence of cerebral microbleeds: the Rotterdam Scan Study, Arch Neurol, 2009, 66, 714–720 http://dx.doi.org/10.1001/archneurol.2009.42[WoS][Crossref]
• [36] Sun J., Soo Y. O., Lam W. W., Wong K. S., Zeng J. S., Fan Y. H., Different distribution patterns of cerebral microbleeds in acute ischemic stroke patients with and without hypertension, Eur Neurol, 2009, 62, 298–303 http://dx.doi.org/10.1159/000235850[WoS][Crossref]
• [37] Woo D., Sauerbeck L. R., Kissela B. M., Khoury J. C., Szaflarski J. P., Gebel J., et al., Genetic and environmental risk factors for intracerebral hemorrhage: preliminary results of a populationbased study, Stroke, 2002, 33, 1190–1195 http://dx.doi.org/10.1161/01.STR.0000014774.88027.22[Crossref]
• [38] Qureshi A. I., Tuhrim S., Broderick J. P., Batjer H. H., Hondo H., Hanley D. F., Spontaneous intracerebral hemorrhage, N Engl J Med, 2001, 344, 1450–1460 http://dx.doi.org/10.1056/NEJM200105103441907[Crossref]
• [39] Naka H., Nomura E., Takahashi T., Wakabayashi S., Mimori Y., Kajikawa H., et al., Combinations of the presence or absence of cerebral microbleeds and advanced white matter hyperintensity as predictors of subsequent stroke types, AJNR Am J Neuroradiol, 2006, 27, 830–835

Identifiers

DOI

10.2478/s11536-011-0019-z