Key result
Deep white matter hyperintensity, but not periventricular hyperintensity, was independently associated with left ventricular hypertrophy in patients with acute ischemic stroke (OR 2.0; 95% CI 1.0-4.0).
Why the study?
Although white matter hyperintensities are associated with left ventricular hypertrophy, it remains unclear whether periventricular or deep white matter hyperintensities are specifically associated with LVH.
Are periventricular and deep white matter hyperintensities associated with left ventricular hypertrophy in patients with acute ischemic stroke?
Observational (n=272)
Are periventricular and deep white matter hyperintensities associated with left ventricular hypertrophy in patients with acute ischemic stroke?
Deep white matter hyperintensity, but not periventricular white matter hyperintensity, is independently associated with left ventricular hypertrophy in patients with acute ischemic stroke.
Deep WMH-LVH association in acute ischemic stroke is hypothesis-generating; prospective studies needed before any clinical consideration.
BACKGROUND AND PURPOSE: White matter hyperintensities (WMHs) are associated with the presence of left ventricular hypertrophy (LVH). It is unclear if periventricular WMH (PV-WMH) and or deep WMH (D-WMH) are associated with LVH. We evaluated the association of PV-WMH and D-WMH with common transthoracic echocardiogram abnormalities, including LVH in acute ischemic stroke. METHODS: PV-WMH and D-WMH were graded on a 0-3 score based on the Fazekas scale. Patients were categorized into clinically significant PV-WMH and D-WMH (score 2-3) and controls (score 0-1). Multivariate logistic regression analysis was performed to determine abnormalities on echocardiogram associated with PV-WMH and D-WMH. RESULTS: Among 272 patients, 137 patients had PV-WMH and 93 patients had D-WMH with a score of 2-3 on Fazekas scale. Compared to controls, patients with PV-WMH (mean age±standard deviation: 60.8±14.4 vs. 73.8±11.2 years) and D-WMH (63.4±14.4 vs. 75.0±11.1 years) were older. Compared to controls, PV-WMH was associated with history of stroke (22 [16%] vs. 37 [27%], p = .03) and valvular calcification (33 [24%] vs. 61 [45%], p = .0005); D-WMH was associated with history of atrial fibrillation (25 [14%] vs. 22 [24%], p = .04), valvular calcification (50 [28%] vs. 44 [47%], p = .001), and LVH (30 [17%] vs. 25 [27%], p = .049). In multivariate analysis, PV-WMH was associated with age (odds ratio [OR] = 1.09; 95% confidence interval [CI] = 1.06-1.12) and stroke history (OR = 2.1; 95% CI = 1.1-4.1), and D-WMH was associated with age (OR = 1.07; 95% CI = 1.05-1.10) and LVH (OR = 2.0; 95% CI = 1.0-4.0). CONCLUSION: LVH is associated with D-WMH but not with PV-WMH. Although valvular calcification is common, it is likely age related than due to WMH.
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Nagaraja et al. (2021) conducted an observational in Acute ischemic stroke (n=272). Deep white matter hyperintensity (D-WMH) vs. Controls (Fazekas score 0-1) was evaluated on Left ventricular hypertrophy (LVH) (OR 2.0, 95% CI 1.0-4.0, p=0.049). Deep white matter hyperintensity, but not periventricular hyperintensity, was independently associated with left ventricular hypertrophy in patients with acute ischemic stroke (OR 2.0; 95% CI 1.0-4.0).
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