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Published on: April 23, 2021
Left Ventricular Hypertrophy and Cerebral Small Vessel Disease: A Systematic Review and Meta-Analysis
Andreas Papadopoulos1, Konstantinos Palaiopanos1, Athanasios P Protogerou2
1Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Insights
Left ventricular hypertrophy (LVH) is linked to cerebral small vessel disease (CSVD) markers like lacunes and white matter hyperintensities. This association persists independently of other vascular risks, suggesting LVH is a novel risk factor for CSVD.
Area of Science:
- Cardiology
- Neurology
- Radiology
Background:
- Left ventricular hypertrophy (LVH) is a known risk factor for stroke and dementia.
- The association between LVH and cerebral small vessel disease (CSVD) has not been previously established.
- CSVD encompasses neuroimaging markers such as lacunes, white matter hyperintensities (WMHs), and cerebral microbleeds (CMBs).
Conclusions:
- Left ventricular hypertrophy is independently associated with neuroimaging markers of cerebral small vessel disease.
- LVH represents a novel risk factor for CSVD.
- These findings underscore the connection between subclinical cardiac dysfunction and brain damage.
Background And Purpose:
Left ventricular hypertrophy (LVH) is associated with the risk of stroke and dementia independently of other vascular risk factors, but its association with cerebral small vessel disease (CSVD) remains unknown. Here, we employed a systematic review and meta-analysis to address this gap.
Methods:
Following the MOOSE guidelines (PROSPERO protocol: CRD42018110305), we systematically searched the literature for studies exploring the association between LVH or left ventricular (LV) mass, with neuroimaging markers of CSVD (lacunes, white matter hyperintensities [WMHs], cerebral microbleeds [CMBs]). We evaluated risk of bias and pooled association estimates with random-effects meta-analyses.
Results:
We identified 31 studies (n=25,562) meeting our eligibility criteria. In meta-analysis, LVH was associated with lacunes and extensive WMHs in studies of the general population (odds ratio [OR]lacunes, 1.49; 95% confidence interval [CI], 1.12 to 2.00) (ORWMH, 1.73; 95% CI, 1.38 to 2.17) and studies in highrisk populations (ORlacunes: 2.39; 95% CI, 1.32 to 4.32) (ORWMH, 2.01; 95% CI, 1.45 to 2.80). The.
Results:
remained stable in general population studies adjusting for hypertension and other vascular risk factors, as well as in sub-analyses by LVH assessment method (echocardiography/electrocardiogram), study design (cross-sectional/cohort), and study quality. Across LV morphology patterns, we found gradually increasing ORs for concentric remodelling, eccentric hypertrophy, and concentric hypertrophy, as compared to normal LV geometry. LVH was further associated with CMBs in high-risk population studies.
Conclusion:
s LVH is associated with neuroimaging markers of CSVD independently of hypertension and other vascular risk factors. Our findings suggest LVH as a novel risk factor for CSVD and highlight the link between subclinical heart and brain damage.
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