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Ischemic cerebrovascular complications and risk factors in idiopathic hypertrophic subaortic stenosis
J W Russell1, J Biller, Z D Hajduczok
1Department of Neurology, University of Iowa College of Medicine, Iowa City.
Insights
Idiopathic hypertrophic subaortic stenosis (IHSS) patients face cerebrovascular risks, including stroke. This study identified key risk factors for stroke in IHSS, highlighting the importance of early detection and management.
Area of Science:
- Cardiology
- Neurology
- Medical Research
Background:
- Idiopathic hypertrophic subaortic stenosis (IHSS) is a cardiovascular condition.
- Cerebrovascular complications are a concern in IHSS patients.
- Previous studies have not fully elucidated stroke risks in IHSS.
Purpose of the Study:
- To investigate the incidence and timing of cerebrovascular complications in patients with IHSS.
- To identify specific risk factors associated with stroke in this population.
Main Methods:
- A cohort of 119 patients with IHSS, diagnosed via echocardiography, was followed for a mean of 6.5 years.
- Cerebral ischemic events were recorded and analyzed.
- Risk factors including sex, cardiac history, and comorbidities were assessed.
Main Results:
- 22% of patients experienced cerebral ischemic events, with stroke being the initial presentation in 5 patients.
- Risk factors for stroke included female sex, mitral anulus calcification, hypertension, and atrioventricular conduction delay.
- Cardioembolic events correlated with atrial fibrillation and left atrial enlargement; atheroembolic events with hypertension.
Conclusions:
- Patients with IHSS have a significant risk of cerebrovascular complications, including stroke.
- Specific clinical and echocardiographic findings are associated with an increased risk of stroke in IHSS.
- Stroke can be an initial presenting symptom of IHSS.
Abstract:
To determine the risk and time to cerebrovascular complications with idiopathic hypertrophic subaortic stenosis, we studied 119 patients (66 men and 53 women) with evidence of this disease based on strict echocardiographic criteria and followed them up for a mean +/- SEM of 6.5 +/- 0.6 years. Cerebral ischemic events occurred in 26 patients (22%), and in five patients stroke was the initial presenting event. Men had cardiac symptoms at a younger age than women, but there was no significant difference in age at the time of stroke. Cardioembolic cerebrovascular events were associated with atrial fibrillation and left atrial enlargement, whereas atheroembolic events were associated with hypertension. An increased risk of stroke was associated with female sex, mitral anulus calcification, hypertension, and atrioventricular conduction delay. Unlike most previous series, this study shows that patients with idiopathic hypertrophic subaortic stenosis may present with stroke.