Published Online
on June 12, 2003

A more recent version of this article appeared on July 1, 2003

This Article Full Text (PDF) All Versions of this Article: 34/7/1766    most recent 01.STR.0000078310.98444.1Dv1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Selvetella, G. Articles by Lembo, G. Search for Related Content PubMed PubMed Citation Articles by Selvetella, G. Articles by Lembo, G. Pubmed/NCBI databases Medline Plus Health Information High Blood Pressure Related Collections Hypertrophy Electrocardiology Echocardiography Cerebral Lacunes Computerized tomography and Magnetic Resonance Imaging

Submitted on February 6, 2003
Accepted on February 24, 2003

Left Ventricular Hypertrophy Is Associated With Asymptomatic Cerebral Damage in Hypertensive Patients

Giulio Selvetella MD; Antonella Notte MD; Angelo Maffei MSc; Valentina Calistri MD; Virginia Scamardella; Giacomo Frati MD; Bruno Trimarco MD; Claudio Colonnese MD; and Giuseppe Lembo MD, PhD^*

From the Departments of Angio-Cardio-Neurology (G.S., A.N., A.M., V.S., G.F., B.T., G.L.) and of Neuro-Radiology (V.C., C.C.), IRCCS Neuromed, Pozzilli (IS), and the Neuro-Radiology Section (C.C.) and Department of Experimental Medicine and Pathology (G.L.), Università La Sapienza, Rome, Italy.

^* To whom correspondence should be addressed. E-mail: lembo{at}neuromed.it.

Background and Purpose--It has been demonstrated that left ventricular hypertrophy (LVH) confers an increased risk for major cerebrovascular events. However, it is still uncertain whether there is an association between LVH and asymptomatic cerebrovascular damage in hypertensive patients. In this study, we investigated the relation between LVH, evaluated by both echocardiography (Echo-LVH) and electrocardiography (ECG-LVH), and preclinical cerebral damage, as identified by magnetic resonance imaging.

Methods--One hundred ninety-five consecutive patients were enrolled in the study. We evaluated other risk factors such as age, sex, presence of diabetes, cholesterol levels, smoking status, heart rate, and systolic and diastolic blood pressure. Asymptomatic cerebrovascular damage was considered silent cerebral lesions: punctate lesions, lacunes, and territorial lesions. Patients were divided into 2 groups according to the presence of asymptomatic brain lesions.

Results--The 2 groups of patients differed only in terms of age and systolic pressure. More importantly, the prevalence of Echo-LVH (83% versus 47.7%, P<0.001) and ECG-LVH (56% versus 22%, P<0.001) was significantly higher in patients with asymptomatic brain lesions. A multivariate analysis allowed us to recognize LVH as the only independent predictor for the presence of ischemic lacunes (P<0.001). Moreover, we evaluated the impact of left ventricular geometry on asymptomatic cerebrovascular damage, and we found that hypertensives with concentric hypertrophy displayed more pronounced asymptomatic cerebrovascular damage compared with patients with eccentric hypertrophy.

Conclusions--Our study demonstrates that LVH is associated with cerebral damage even in the absence of clinical symptoms. Thus, the presence of cardiac damage provides important prognostic clues about the presence of asymptomatic cerebral damage.

Key words: cerebral infarction • electrocardiography • hypertension • magnetic resonance imaging • risk factors

This article has been cited by other articles:

				E. R. Fox, N. Alnabhan, A. D. Penman, K. R. Butler, H. A. Taylor Jr, T. N. Skelton, and T. H. Mosley Jr Echocardiographic Left Ventricular Mass Index Predicts Incident Stroke in African Americans: Atherosclerosis Risk in Communities (ARIC) Study Stroke, October 1, 2007; 38(10): 2686 - 2691. [Abstract] [Full Text] [PDF]

				M. F. Elias, L. M. Sullivan, P. K. Elias, R. B. D'Agostino Sr, P. A. Wolf, S. Seshadri, R. Au, E. J. Benjamin, and R. S. Vasan Left Ventricular Mass, Blood Pressure, and Lowered Cognitive Performance in the Framingham Offspring Hypertension, March 1, 2007; 49(3): 439 - 445. [Abstract] [Full Text] [PDF]

				O. Kluck, M. Berman, A. Stamler, G. Sahar, A. Kogan, E. Porat, and A. Sagie Value of echocardiography for stroke and mortality prediction following coronary artery bypass grafting Interactive CardioVascular and Thoracic Surgery, February 1, 2007; 6(1): 30 - 34. [Abstract] [Full Text] [PDF]

				B. van Harten, F.-E. de Leeuw, H. C. Weinstein, P. Scheltens, and G. J. Biessels Brain Imaging in Patients With Diabetes: A systematic review. Diabetes Care, November 1, 2006; 29(11): 2539 - 2548. [Full Text] [PDF]

				J. C. Hueb, S. G. Zanati, K. Okoshi, C. N. Raffin, L. V. de Arruda Silveira, and B. B. Matsubara Association Between Atherosclerotic Aortic Plaques and Left Ventricular Hypertrophy in Patients With Cerebrovascular Events Stroke, April 1, 2006; 37(4): 958 - 962. [Abstract] [Full Text] [PDF]

				H.-C. Koennecke Cerebral microbleeds on MRI: Prevalence, associations, and potential clinical implications Neurology, January 24, 2006; 66(2): 165 - 171. [Abstract] [Full Text] [PDF]

				E. R. Fox, H. A. Taylor Jr, E. J. Benjamin, J. Ding, P. R. Liebson, D. Arnett, E. M. Quin, and T. N. Skelton Left Ventricular Mass Indexed to Height and Prevalent MRI Cerebrovascular Disease in an African American Cohort: The Atherosclerotic Risk in Communities Study Stroke, March 1, 2005; 36(3): 546 - 550. [Abstract] [Full Text] [PDF]

				S. -H. Lee, J. -M. Park, S. -J. Kwon, H. Kim, Y. H. Kim, J. K. Roh, and B. W. Yoon Left ventricular hypertrophy is associated with cerebral microbleeds in hypertensive patients Neurology, July 13, 2004; 63(1): 16 - 21. [Abstract] [Full Text] [PDF]

				O. Fustinoni Editorial Comment--Left Ventricular Hypertrophy: An Unseemly Risk Factor for Stroke? Stroke, October 1, 2003; 34(10): 2385 - 2386. [Full Text] [PDF]