Cardiac Organ Damage in Young Adults with Cryptogenic Ischaemic Stroke: The SECRETO Study
Rune Krogh Eilertsen1,2, Eva Gerdts3,4, Ulrike Waje-Andreassen5
1Department of Clinical Science, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway. rune.eilertsen@uib.no.
Insights
Young patients with cryptogenic ischemic stroke (CIS) show higher rates of abnormal heart geometry. Obesity and high blood pressure are linked to this cardiac damage, highlighting the need for weight and blood pressure control to prevent future cardiovascular events.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- Cardiac organ damage (OD) increases cardiovascular disease risk.
- Limited data exists on cardiac OD in young patients with cryptogenic ischemic stroke (CIS).
Purpose of the Study:
- To determine the prevalence and factors associated with cardiac OD in young CIS patients compared to controls.
- Investigate cardiac organ damage in cryptogenic ischemic stroke.
Main Methods:
- Analysis of 427 young CIS patients and 361 age/sex-matched controls from the SECRETO study.
- Cardiac organ damage defined by abnormal left ventricular (LV) geometry or left atrial enlargement (LAE) via echocardiography.
- Sex-specific thresholds used for defining cardiac organ damage.
Main Results:
- CIS patients had higher rates of obesity, smoking, patent foramen ovale (PFO), and abnormal LV geometry compared to controls.
- Abnormal LV geometry was significantly associated with CIS (OR 1.86).
- Obesity linked to abnormal LV geometry and LAE; higher systolic blood pressure linked to abnormal LV geometry in CIS patients.
Conclusions:
- Abnormal LV geometry is more prevalent in young CIS patients and associated with higher blood pressure and obesity.
- Emphasizes the importance of blood pressure and weight management in CIS patients.
- Suggests interventions to prevent cardiac OD progression and recurrent cardiovascular events.
Introduction:
Cardiac organ damage (OD) is associated with increased risk of cardiovascular disease. However, limited knowledge exists on cardiac OD in young patients with cryptogenic ischaemic stroke (CIS).
Aim:
To explore prevalence and covariates of cardiac OD in patients with CIS compared to controls participating in the SECRETO study.
Methods:
We analysed data from 427 patients with CIS aged <50 years and 361 age- and sex-matched controls. OD was defined as presence of abnormal left ventricular (LV) geometry (LV hypertrophy or concentric remodelling) or left atrial enlargement (LAE) assessed by echocardiography, using sex-specific threshold values.
Results:
Compared to controls, patients had higher prevalences of obesity and tobacco smoking, patent foramen ovale (PFO) (52% vs. 25%) and abnormal LV geometry (12% vs. 7%, all p < 0.01), while presence of LAE did not differ. In multivariable analyses, CIS was associated with presence of abnormal LV geometry (odds ratio 1.86 [95% confidence interval 1.09-3.20], p=0.024). In separate multivariable analyses in patients only, obesity was associated with both abnormal LV geometry and LAE (both p < 0.01), and higher systolic blood pressure only with presence of abnormal LV geometry (p < 0.001). No significant association with PFO was found.
Conclusion:
In young patients with CIS participating in the SECRETO study, abnormal LV geometry was more prevalent compared to age- and sex-matched controls and associated with presence of higher blood pressure and obesity. The results point to the importance of blood pressure and weight control in CIS to prevent progression of cardiac OD and recurrent cardiovascular events.
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