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Published on: February 20, 2017
Echocardiographic left ventricular mass index predicts incident stroke in African Americans: Atherosclerosis Risk in
Ervin R Fox1, Nabhan Alnabhan, Alan D Penman
1Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, 2500, N State St, Jackson, MS 39216, USA. efox@medicine.umsmed.edu
Insights
Left ventricular mass index (LVMI), measured by echocardiography, independently predicts ischemic stroke in African Americans. This finding highlights LVMI as a crucial risk factor beyond traditional clinical indicators.
Area of Science:
- Cardiology
- Epidemiology
- Medical Imaging
Background:
- Left ventricular mass is theorized to link to stroke risk.
- Few large population studies assess echocardiographic left ventricular mass index (LVMI) for stroke prediction in African Americans.
Purpose of the Study:
- To investigate the predictive value of echocardiographically derived LVMI for incident stroke in a large African American cohort.
- To determine if LVMI is an independent predictor of stroke after accounting for traditional risk factors.
Main Methods:
- Utilized data from the Jackson cohort of the Atherosclerotic Risk in Communities study.
- Included 1792 participants who underwent echocardiography and were followed for incident ischemic stroke.
- Statistical analysis adjusted for multiple clinical and echocardiographic variables.
Main Results:
- A total of 98 incident strokes occurred during a median follow-up of 8.8 years.
- Higher LVMI was independently associated with increased risk of ischemic stroke (aHR per 10 g/m(2.7) increment=1.15; 95% CI, 1.02 to 1.28).
- This association remained significant after adjusting for traditional risk factors, left atrial size, and mitral annular calcification.
Conclusions:
- Echocardiographic LVMI is an independent predictor of incident ischemic stroke in African Americans.
- LVMI provides valuable prognostic information beyond established clinical risk factors.
- Findings emphasize the importance of assessing LVMI in cardiovascular risk stratification for this population.
Background And Purpose:
Despite theories that link stroke to left ventricular mass, few large, population-based studies have examined the predictive value of echocardiographically derived left ventricular mass index (LVMI) to incident stroke in African Americans.
Methods:
Participants in the Jackson cohort of the Atherosclerotic Risk in Communities study have had extensive baseline evaluations, have undergone echocardiography during the third examination (1993-1995), and have been followed up for incident cardiovascular disease including ischemic stroke.
Results:
The study population consisted of 1792 participants, of whom 639 (35.7%) were men and the mean+/-SD age was 58.8+/-5.7 years. Compared with those without ischemic stroke, those with ischemic stroke had a higher frequency of hypertension (85.6% vs 58.7%) and diabetes (46.9% vs 21.0%). Left ventricular hypertrophy was more prevalent in those with stroke (62.2% vs 38.6%). During a median follow-up of 8.8 years, 98 incident strokes occurred (6.5 per 1000 person-years). LVMI was independently associated with stroke after adjusting for age, sex, hypertension, systolic blood pressure, smoking, diabetes, total to HDL cholesterol ratio, body mass index, and low left ventricular ejection fraction (adjusted hazard ratio per 10 g/m(2.7) increment of LVMI=1.15; 95% CI, 1.02 to 1.28). The relation remained statistically significant after adding left atrial size and mitral annular calcification to the multivariable model.
Conclusions:
In this large, population-based African American cohort, we found that echocardiographic LVMI was an independent predictor of incident ischemic stroke even after taking into account traditional clinical risk factors.
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