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Left ventricular hypertrophy is associated with asymptomatic cerebral damage in hypertensive patients
Giulio Selvetella1, Antonella Notte, Angelo Maffei
1Department of Angio-Cardio-Neurology, Università La Sapienza, Rome, Italy.
Insights
Left ventricular hypertrophy (LVH) is linked to silent brain damage in hypertensive patients. Cardiac damage indicators like LVH may predict preclinical cerebral lesions, highlighting the importance of cardiovascular health assessment.
Area of Science:
- Cardiology
- Neurology
- Hypertension Research
Background:
- Left ventricular hypertrophy (LVH) is a known risk factor for major cerebrovascular events.
- The association between LVH and asymptomatic cerebrovascular damage in hypertensive individuals remains unclear.
- Preclinical cerebral damage can manifest as silent cerebral lesions.
Purpose of the Study:
- To investigate the relationship between LVH, assessed by echocardiography (Echo-LVH) and electrocardiography (ECG-LVH), and preclinical cerebral damage.
- To identify predictors of asymptomatic cerebrovascular damage in hypertensive patients.
- To explore the impact of left ventricular geometry on cerebral damage.
Main Methods:
- 195 consecutive hypertensive patients were enrolled.
- Evaluated risk factors included age, sex, diabetes, cholesterol, smoking, heart rate, and blood pressure.
- Asymptomatic cerebrovascular damage was assessed using MRI to identify silent cerebral lesions (punctate lesions, lacunes, territorial lesions).
Main Results:
- Patients with asymptomatic brain lesions had significantly higher prevalence of Echo-LVH (83% vs 47.7%) and ECG-LVH (56% vs 22%).
- LVH was identified as the sole independent predictor of ischemic lacunes (P<0.001).
- Concentric hypertrophy was associated with more pronounced asymptomatic cerebrovascular damage compared to eccentric hypertrophy.
Conclusions:
- LVH is significantly associated with cerebral damage, even in asymptomatic hypertensive patients.
- Cardiac damage, specifically LVH, serves as a crucial prognostic indicator for preclinical cerebral damage.
- Assessing LVH can provide valuable insights into the risk of silent cerebrovascular disease.
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.