Left ventricular mass and geometry and the risk of ischemic stroke

Marco R. Di Tullio, Donna R. Zwas, Ralph L Sacco, Robert R. Sciacca, Shunichi Homma

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

Background and Purpose - Left ventricular hypertrophy (LVH) is a risk factor for cardiovascular events, but its effect on ischemic stroke risk is established mainly in whites. The effect of LV geometry on stroke risk has not been defined. The aim of the present study was to evaluate whether LVH and LV geometry are independently associated with increased ischemic stroke risk in a multiethnic population. Methods - A population-based case-control study was conducted on 394 patients with first ischemic stroke and 413 age-, sex-, and race-ethnicity-matched community control subjects. LV mass was measured by transthoracic echocardiography. LV geometric patterns (normal, concentric remodeling, concentric or eccentric hypertrophy) were identified. Stroke risk associated with LVH and different LV geometric patterns was assessed by conditional logistic regression analysis in the overall group and age, sex, and race-ethnic strata, with adjustment for established stroke risk factors. Results - Concentric hypertrophy carried the greatest stroke risk (adjusted odds ratio [OR], 3.5; 95% confidence interval [CI], 2.0 to 6.2), followed by eccentric hypertrophy (adjusted OR, 2.4; 95% CI, 2.0 to 4.3). Concentric remodeling carried slightly increased stroke risk (adjusted OR, 1.7; 95% CI, 1. 0 to 2.9). Increased LV relative wall thickness was independently associated with stroke after adjustment for LV mass (OR, 1.6; 95% CI, 1.1 to 2.3). Conclusions - LVH and abnormal LV geometry are independently associated with increased stroke risk. LVH is strongly associated with ischemic stroke in all age, sex, and race-ethnic subgroups. Increased LV relative wall thickness imparts an increased stroke risk after adjustment for LV mass and is of additional value in stroke risk prediction.

Original languageEnglish
Pages (from-to)2380-2384
Number of pages5
JournalStroke
Volume34
Issue number10
DOIs
StatePublished - Oct 1 2003
Externally publishedYes

Fingerprint

Stroke
Left Ventricular Hypertrophy
Odds Ratio
Confidence Intervals
Hypertrophy
Risk Adjustment
Population
Echocardiography
Case-Control Studies
Age Groups
Logistic Models
Regression Analysis

Keywords

  • Echocardiography
  • Heart ventricle
  • Hypertrophy, left ventricular
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Left ventricular mass and geometry and the risk of ischemic stroke. / Di Tullio, Marco R.; Zwas, Donna R.; Sacco, Ralph L; Sciacca, Robert R.; Homma, Shunichi.

In: Stroke, Vol. 34, No. 10, 01.10.2003, p. 2380-2384.

Research output: Contribution to journalArticle

Di Tullio, MR, Zwas, DR, Sacco, RL, Sciacca, RR & Homma, S 2003, 'Left ventricular mass and geometry and the risk of ischemic stroke', Stroke, vol. 34, no. 10, pp. 2380-2384. https://doi.org/10.1161/01.STR.0000089680.77236.60
Di Tullio, Marco R. ; Zwas, Donna R. ; Sacco, Ralph L ; Sciacca, Robert R. ; Homma, Shunichi. / Left ventricular mass and geometry and the risk of ischemic stroke. In: Stroke. 2003 ; Vol. 34, No. 10. pp. 2380-2384.
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AU - Di Tullio, Marco R.

AU - Zwas, Donna R.

AU - Sacco, Ralph L

AU - Sciacca, Robert R.

AU - Homma, Shunichi

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N2 - Background and Purpose - Left ventricular hypertrophy (LVH) is a risk factor for cardiovascular events, but its effect on ischemic stroke risk is established mainly in whites. The effect of LV geometry on stroke risk has not been defined. The aim of the present study was to evaluate whether LVH and LV geometry are independently associated with increased ischemic stroke risk in a multiethnic population. Methods - A population-based case-control study was conducted on 394 patients with first ischemic stroke and 413 age-, sex-, and race-ethnicity-matched community control subjects. LV mass was measured by transthoracic echocardiography. LV geometric patterns (normal, concentric remodeling, concentric or eccentric hypertrophy) were identified. Stroke risk associated with LVH and different LV geometric patterns was assessed by conditional logistic regression analysis in the overall group and age, sex, and race-ethnic strata, with adjustment for established stroke risk factors. Results - Concentric hypertrophy carried the greatest stroke risk (adjusted odds ratio [OR], 3.5; 95% confidence interval [CI], 2.0 to 6.2), followed by eccentric hypertrophy (adjusted OR, 2.4; 95% CI, 2.0 to 4.3). Concentric remodeling carried slightly increased stroke risk (adjusted OR, 1.7; 95% CI, 1. 0 to 2.9). Increased LV relative wall thickness was independently associated with stroke after adjustment for LV mass (OR, 1.6; 95% CI, 1.1 to 2.3). Conclusions - LVH and abnormal LV geometry are independently associated with increased stroke risk. LVH is strongly associated with ischemic stroke in all age, sex, and race-ethnic subgroups. Increased LV relative wall thickness imparts an increased stroke risk after adjustment for LV mass and is of additional value in stroke risk prediction.

AB - Background and Purpose - Left ventricular hypertrophy (LVH) is a risk factor for cardiovascular events, but its effect on ischemic stroke risk is established mainly in whites. The effect of LV geometry on stroke risk has not been defined. The aim of the present study was to evaluate whether LVH and LV geometry are independently associated with increased ischemic stroke risk in a multiethnic population. Methods - A population-based case-control study was conducted on 394 patients with first ischemic stroke and 413 age-, sex-, and race-ethnicity-matched community control subjects. LV mass was measured by transthoracic echocardiography. LV geometric patterns (normal, concentric remodeling, concentric or eccentric hypertrophy) were identified. Stroke risk associated with LVH and different LV geometric patterns was assessed by conditional logistic regression analysis in the overall group and age, sex, and race-ethnic strata, with adjustment for established stroke risk factors. Results - Concentric hypertrophy carried the greatest stroke risk (adjusted odds ratio [OR], 3.5; 95% confidence interval [CI], 2.0 to 6.2), followed by eccentric hypertrophy (adjusted OR, 2.4; 95% CI, 2.0 to 4.3). Concentric remodeling carried slightly increased stroke risk (adjusted OR, 1.7; 95% CI, 1. 0 to 2.9). Increased LV relative wall thickness was independently associated with stroke after adjustment for LV mass (OR, 1.6; 95% CI, 1.1 to 2.3). Conclusions - LVH and abnormal LV geometry are independently associated with increased stroke risk. LVH is strongly associated with ischemic stroke in all age, sex, and race-ethnic subgroups. Increased LV relative wall thickness imparts an increased stroke risk after adjustment for LV mass and is of additional value in stroke risk prediction.

KW - Echocardiography

KW - Heart ventricle

KW - Hypertrophy, left ventricular

KW - Stroke

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