Left ventricular mass-geometry and silent cerebrovascular disease: The Cardiovascular Abnormalities and Brain Lesions (CABL) study

Koki Nakanishi, Zhezhen Jin, Shunichi Homma, Mitchell S V Elkind, Tatjana Rundek, Aylin Tugcu, Mitsuhiro Yoshita, Charles DeCarli, Clinton B Wright, Ralph L Sacco, Marco R. Di Tullio

Research output: Contribution to journalArticle

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Abstract

Background Although abnormal left ventricular geometric patterns have prognostic value for morbidity and mortality, their possible association with silent cerebrovascular disease has not been extensively evaluated. Methods We examined 665 participants in the CABL study who underwent transthoracic echocardiography and brain magnetic resonance imaging. Participants were divided into 4 geometric patterns: normal geometry (n = 397), concentric remodeling (n = 89), eccentric hypertrophy (n = 126), and concentric hypertrophy (n = 53). Subclinical cerebrovascular disease was defined as silent brain infarcts (SBIs) and white matter hyperintensity volume (WMHV; expressed as log-transformed percentage of the total cranial volume). Results Silent brain infarcts were observed in 94 participants (14%). Mean log-WMHV was −0.97 ± 0.93. Concentric hypertrophy carried the greatest risk for both SBI (adjusted odds ratio [OR] 3.39, P < .001) and upper quartile of log-WMHV (adjusted OR 3.35, P < .001), followed by eccentric hypertrophy (adjusted ORs 2.52 [P = .001 for SBI] and 1.96 [P = .004] for log-WMHV). Concentric remodeling was not associated with subclinical brain disease. In subgroup analyses, concentric and eccentric hypertrophies were significantly associated with SBI and WMHV in both genders and nonobese participants, but differed for SBI by age (all ages for eccentric hypertrophy, only patients ≥70 years for concentric hypertrophy) and by race-ethnicity (Hispanics for eccentric hypertrophy, blacks for concentric hypertrophy; no association in whites). Conclusions Left ventricular hypertrophy, with both eccentric and concentric patterns, was significantly associated with subclinical cerebrovascular disease in a multiethnic stroke-free general population. Left ventricular geometric patterns may carry different risks for silent cerebrovascular disease in different sex, age, race-ethnic, and body size subgroups.

Original languageEnglish (US)
Pages (from-to)85-92
Number of pages8
JournalAmerican Heart Journal
Volume185
DOIs
StatePublished - Mar 1 2017

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Cardiovascular Abnormalities
Cerebrovascular Disorders
Hypertrophy
Brain
Odds Ratio
Body Size
Brain Diseases
Left Ventricular Hypertrophy
Hispanic Americans
Echocardiography
Stroke
Magnetic Resonance Imaging
Morbidity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Left ventricular mass-geometry and silent cerebrovascular disease : The Cardiovascular Abnormalities and Brain Lesions (CABL) study. / Nakanishi, Koki; Jin, Zhezhen; Homma, Shunichi; Elkind, Mitchell S V; Rundek, Tatjana; Tugcu, Aylin; Yoshita, Mitsuhiro; DeCarli, Charles; Wright, Clinton B; Sacco, Ralph L; Di Tullio, Marco R.

In: American Heart Journal, Vol. 185, 01.03.2017, p. 85-92.

Research output: Contribution to journalArticle

Nakanishi, Koki ; Jin, Zhezhen ; Homma, Shunichi ; Elkind, Mitchell S V ; Rundek, Tatjana ; Tugcu, Aylin ; Yoshita, Mitsuhiro ; DeCarli, Charles ; Wright, Clinton B ; Sacco, Ralph L ; Di Tullio, Marco R. / Left ventricular mass-geometry and silent cerebrovascular disease : The Cardiovascular Abnormalities and Brain Lesions (CABL) study. In: American Heart Journal. 2017 ; Vol. 185. pp. 85-92.
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T2 - The Cardiovascular Abnormalities and Brain Lesions (CABL) study

AU - Nakanishi, Koki

AU - Jin, Zhezhen

AU - Homma, Shunichi

AU - Elkind, Mitchell S V

AU - Rundek, Tatjana

AU - Tugcu, Aylin

AU - Yoshita, Mitsuhiro

AU - DeCarli, Charles

AU - Wright, Clinton B

AU - Sacco, Ralph L

AU - Di Tullio, Marco R.

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N2 - Background Although abnormal left ventricular geometric patterns have prognostic value for morbidity and mortality, their possible association with silent cerebrovascular disease has not been extensively evaluated. Methods We examined 665 participants in the CABL study who underwent transthoracic echocardiography and brain magnetic resonance imaging. Participants were divided into 4 geometric patterns: normal geometry (n = 397), concentric remodeling (n = 89), eccentric hypertrophy (n = 126), and concentric hypertrophy (n = 53). Subclinical cerebrovascular disease was defined as silent brain infarcts (SBIs) and white matter hyperintensity volume (WMHV; expressed as log-transformed percentage of the total cranial volume). Results Silent brain infarcts were observed in 94 participants (14%). Mean log-WMHV was −0.97 ± 0.93. Concentric hypertrophy carried the greatest risk for both SBI (adjusted odds ratio [OR] 3.39, P < .001) and upper quartile of log-WMHV (adjusted OR 3.35, P < .001), followed by eccentric hypertrophy (adjusted ORs 2.52 [P = .001 for SBI] and 1.96 [P = .004] for log-WMHV). Concentric remodeling was not associated with subclinical brain disease. In subgroup analyses, concentric and eccentric hypertrophies were significantly associated with SBI and WMHV in both genders and nonobese participants, but differed for SBI by age (all ages for eccentric hypertrophy, only patients ≥70 years for concentric hypertrophy) and by race-ethnicity (Hispanics for eccentric hypertrophy, blacks for concentric hypertrophy; no association in whites). Conclusions Left ventricular hypertrophy, with both eccentric and concentric patterns, was significantly associated with subclinical cerebrovascular disease in a multiethnic stroke-free general population. Left ventricular geometric patterns may carry different risks for silent cerebrovascular disease in different sex, age, race-ethnic, and body size subgroups.

AB - Background Although abnormal left ventricular geometric patterns have prognostic value for morbidity and mortality, their possible association with silent cerebrovascular disease has not been extensively evaluated. Methods We examined 665 participants in the CABL study who underwent transthoracic echocardiography and brain magnetic resonance imaging. Participants were divided into 4 geometric patterns: normal geometry (n = 397), concentric remodeling (n = 89), eccentric hypertrophy (n = 126), and concentric hypertrophy (n = 53). Subclinical cerebrovascular disease was defined as silent brain infarcts (SBIs) and white matter hyperintensity volume (WMHV; expressed as log-transformed percentage of the total cranial volume). Results Silent brain infarcts were observed in 94 participants (14%). Mean log-WMHV was −0.97 ± 0.93. Concentric hypertrophy carried the greatest risk for both SBI (adjusted odds ratio [OR] 3.39, P < .001) and upper quartile of log-WMHV (adjusted OR 3.35, P < .001), followed by eccentric hypertrophy (adjusted ORs 2.52 [P = .001 for SBI] and 1.96 [P = .004] for log-WMHV). Concentric remodeling was not associated with subclinical brain disease. In subgroup analyses, concentric and eccentric hypertrophies were significantly associated with SBI and WMHV in both genders and nonobese participants, but differed for SBI by age (all ages for eccentric hypertrophy, only patients ≥70 years for concentric hypertrophy) and by race-ethnicity (Hispanics for eccentric hypertrophy, blacks for concentric hypertrophy; no association in whites). Conclusions Left ventricular hypertrophy, with both eccentric and concentric patterns, was significantly associated with subclinical cerebrovascular disease in a multiethnic stroke-free general population. Left ventricular geometric patterns may carry different risks for silent cerebrovascular disease in different sex, age, race-ethnic, and body size subgroups.

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