Left ventricular hypertrophy is associated with cerebral microbleeds in hypertensive patients

Lee, S. H.; Park, J. M.; Kwon, Sun‐Jung; Kim, H.; Kim, Y. H.; Roh, Jae-Kyu; Yoon, Byung‐Woo

doi:10.1212/01.wnl.0000132525.36804.a1

Cited by 79 publications

(74 citation statements)

References 27 publications

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“…Left ventricular (LV) hypertrophy (LVH), a pathologic increase in LV mass, is associated with cerebrovascular disease,1 white matter hyperintensities,2 and cognitive decline3 in aging individuals, particularly elders with hypertension 4, 5. Increased LV mass index (LV mass/body surface area) is an imaging marker that precedes LVH6 and reflects subclinical pathologic remodeling of the ventricular wall.…”

Section: Introductionmentioning

confidence: 99%

Increased Left Ventricular Mass Index Is Associated With Compromised White Matter Microstructure Among Older Adults

Moore

Liu

Pechman

et al. 2018

JAHA

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BackgroundLeft ventricular (LV) hypertrophy is associated with cerebrovascular disease and cognitive decline. Increased LV mass index is a subclinical imaging marker that precedes overt LV hypertrophy. This study relates LV mass index to white matter microstructure and cognition among older adults with normal cognition and mild cognitive impairment.Methods and ResultsVanderbilt Memory & Aging Project participants free of clinical stroke, dementia, and heart failure (n=318, 73±7 years, 58% male, 39% mild cognitive impairment) underwent brain magnetic resonance imaging, cardiac magnetic resonance, and neuropsychological assessment. Voxelwise analyses related LV mass index (g/m2) to diffusion tensor imaging metrics. Models adjusted for age, sex, education, race/ethnicity, Framingham Stroke Risk Profile, cognitive diagnosis, and apolipoprotein E–ε4 status. Secondary analyses included a LV mass index×diagnosis interaction term with follow‐up models stratified by diagnosis. With identical covariates, linear regression models related LV mass index to neuropsychological performances. Increased LV mass index related to altered white matter microstructure (P<0.05). In models stratified by diagnosis, associations between LV mass index and diffusion tensor imaging were present among mild cognitive impairment participants only (P<0.05). LV mass index was related only to worse visuospatial memory performance (β=−0.003, P=0.036), an observation that would not withstand correction for multiple testing.ConclusionsIn the absence of prevalent heart failure and clinical stroke, increased LV mass index corresponds to altered white matter microstructure, particularly among older adults with clinical symptoms of prodromal dementia. Findings highlight the potential link between subclinical LV remodeling and cerebral white matter microstructure vulnerability.

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Section: Introductionmentioning

confidence: 99%

Increased Left Ventricular Mass Index Is Associated With Compromised White Matter Microstructure Among Older Adults

Moore

Liu

Pechman

et al. 2018

JAHA

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“…[2][3][4]10 In contrast, those located solely in the lobar regions have shown no association with SVD or stroke risk, 10 and are thought to have cerebral amyloid angiopathy (CAA) as an underlying mechanism. [2][3][4]10,11 It is interesting to note that recent findings have also identified an association between MBs and Alzheimer disease (AD). [2][3][4] This is conceivable given that MBs are associated with hypertension and CAA, which are both in turn associated with AD and that the amyloid deposits histologically characteristic of AD are frequently attributable to previous MBs.…”

Section: Introductionmentioning

confidence: 99%

Silent cerebral microbleeds associated with arterial stiffness in an apparently healthy subject

et al. 2009

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Silent cerebral microbleeds (MBs) are a common finding in stroke patients, especially those with intracerebral hemorrhage, and are thought to be a marker of future cerebral hemorrhage. Clinically, two distinct forms of MBs have been documented, those observed with either or both stroke or small vessel disease (SVD) and those associated with cerebral amyloid angiopathy. We investigated a possible association between MBs and arterial stiffness in a general population. Subjects were 443 apparently healthy individuals with a mean age of 67.1 ± 8.1 years. The presence of MBs, lacunar infarcts and periventricular hyperintensity (PVH) was determined by 3-tesla magnetic resonance imaging. Carotid intima-media thickness (IMT) was measured by ultrasonography. Arterial stiffness was evaluated by brachial-to-ankle pulse wave velocity (baPWV), and the Framingham stroke risk score (FSRS) was obtained as an integrated cerebrovascular risk factor. The prevalence of MBs was 5.0%. Both baPWV and FSRS were significantly higher in subjects with MBs (1820 ± 308 vs. 1645 ± 325 cm/s, P¼0.014 and 12.1 ± 8.6 vs. 8.9 ± 7.5%, P¼0.047, respectively). Odds ratio of a high baPWV, defined as X1500 cm/s, for the presence of MBs was 6.05 even after correction for confounding parameters, including age and hypertension. This association with high baPWV remained irrespective of MBs location, whether strictly located in the lobes or in the basal ganglia and infratentorial regions. These findings indicate an association between arterial stiffness and the presence of MBs. Assessment of arterial stiffness may be useful in identifying subjects at high risk for the presence of MBs.

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“…LV mass is associated with incident ischemic stroke [6] and asymptomatic cerebrovascular lesions [7][8][9][10][11][12][13][14][15][16][17]. In patients with LV hypertrophy, ischemic subtypes of cerebral small-artery disease (SAD), such as lacunar infarction [10,11] or leukoaraiosis [8,10], are frequent.…”

Section: Introductionmentioning

confidence: 99%

“…In patients with LV hypertrophy, ischemic subtypes of cerebral small-artery disease (SAD), such as lacunar infarction [10,11] or leukoaraiosis [8,10], are frequent. Moreover, a close relationship has been reported between LV hypertrophy and cerebral microbleeds in hypertensive stroke patients [9]. In addition, LV mass is associated with large-artery disease (LAD), such as extracranial carotid artery disease [7,[12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

“…From LV mass and relative wall thickness, 3 abnormal geometric patterns, i.e., concentric LV hypertrophy, eccentric LV hypertrophy, and concentric LV remodeling, are identified that appear to carry different risks for cardiovascular events [19]: concentric hypertrophy (increase in both LV mass and relative wall thickness) carries the highest risk, followed by eccentric hypertrophy (increased LV mass, normal relative wall thickness) [3,5]. In subjects with abnormal LV geometry, asymptomatic cerebral lesions are frequent [7][8][9]20]. Furthermore, abnormal LV geometry is associated with extracranial carotid artery disease [7].…”

Section: Introductionmentioning

confidence: 99%

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Correlations between left ventricular mass index and cerebrovascular lesion

Kang

Lee²,

Kim³

et al. 2011

Open Medicine

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AbstractLeft 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.

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Left ventricular hypertrophy is associated with cerebral microbleeds in hypertensive patients

Abstract: There is a close relationship between CMBs and LV hypertrophy in hypertensive patients with stroke. Thus, CMBs should be understood as one type of cerebral target organ damage by chronic hypertension.

Cited by 79 publications

References 27 publications

Increased Left Ventricular Mass Index Is Associated With Compromised White Matter Microstructure Among Older Adults

Increased Left Ventricular Mass Index Is Associated With Compromised White Matter Microstructure Among Older Adults

Silent cerebral microbleeds associated with arterial stiffness in an apparently healthy subject

Correlations between left ventricular mass index and cerebrovascular lesion

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