Περίληψη:
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. Conclusions 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. © 2020 Korean Stroke Society.
Συγγραφείς:
Papadopoulos, A.
Palaiopanos, K.
Protogerou, A.P.
Paraskevas, G.P.
Tsivgoulis, G.
Georgakis, M.K.
Λέξεις-κλειδιά:
apolipoprotein E; low density lipoprotein cholesterol, Article; atrial fibrillation; body mass; brain hemorrhage; brain ventricle; brain ventricle tumor; cardiovascular risk; cerebrovascular disease; clinical outcome; computer assisted tomography; concentric hypertrophy; diffusion tensor imaging; eccentric hypertrophy; echocardiography; electrocardiogram; fluid attenuated inversion recovery nuclear magnetic resonance imaging; genetic heterogeneity; heart left ventricle hypertrophy; high risk population; human; hypertension; meta analysis; neuroimaging; nuclear magnetic resonance imaging; randomized controlled trial (topic); risk factor; sensitivity analysis; systematic review; transthoracic echocardiography; white matter hyperintensity; white matter lesion
