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Relation of left ventricular hypertrophy and geometry to asymptomatic cerebrovascular damage in essential hypertension.

Relation of left ventricular hypertrophy and geometry to asymptomatic cerebrovascular damage in essential hypertension.

Authors :
Kohara K
Zhao B
Jiang Y
Takata Y
Fukuoka T
Igase M
Miki T
Hiwada K
Source :
The American journal of cardiology [Am J Cardiol] 1999 Feb 01; Vol. 83 (3), pp. 367-70.
Publication Year :
1999

Abstract

Increased left ventricular (LV) mass and abnormal geometry have a powerful prognostic value for cardiovascular morbidity and mortality including stroke. However, there have been no studies on the association between LV hypertrophy and preclinical brain damage in essential hypertensive patients. In the present study, we investigated the relation between LV hypertrophy and asymptomatic cerebrovascular damage identified by magnetic resonance imaging in 150 essential hypertensive patients, with an emphasis on LV geometry. Patients were divided into the following 4 groups according to their LV mass index and relative wall thickness; normal ventricular geometry (n = 50), concentric remodeling (n = 22), eccentric hypertrophy (n = 44), and concentric LV hypertrophy (n = 34). Lacunar lesions and leukoaraiosis were evaluated. The prevalence of lacunae was significantly higher in patients with LV remodeling than in patients with normal LV (chi-square 19.6, p = 0.0002). The number of lacunae was significantly higher in patients with LV hypertrophy than in patients with normal LV or concentric remodeling (F [3,146] = 8.03, p<0.0001). The severity of leukoaraiosis was also significantly greater in patients with LV hypertrophy than in patients with a normal left ventricle (chi-square 14.5, p = 0.02). Stepwise regression analysis confirmed that LV mass index and relative wall thickness, in addition to age and systolic blood pressure, were independent predictors for asymptomatic cerebrovascular damage, even in the absence of neurologic abnormalities. In hypertensive patients, LV hypertrophy, and especially concentric LV hypertrophy, provides important prognostic information on the presence of pre-clinical brain damage.

Details

Language :
English
ISSN :
0002-9149
Volume :
83
Issue :
3
Database :
MEDLINE
Journal :
The American journal of cardiology
Publication Type :
Academic Journal
Accession number :
10072225
Full Text :
https://doi.org/10.1016/s0002-9149(98)00870-4