Echocardiographic Assessment of Hypertensive Left Ventricular Hypertrophy in Patients with Acute Ischemic Stroke or Transient Ischemic Attack

• Published in: Journal of stroke and cerebrovascular diseases 2012-11, Vol.21 (8), p.745-748
• Main Authors: Castilla-Guerra, Luis, MD, PhD, Fernández-Moreno, María del Carmen, MD, Alvarez-Suero, Jesus, MD, Gonzalez, Antonio, MD, PhD
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Antihypertensive Agents - therapeutic use; Brain Ischemia - diagnosis; Brain Ischemia - epidemiology; Brain Ischemia - therapy; Cardiovascular; Chi-Square Distribution; Echocardiography; Female; Humans; hypertension; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - epidemiology; Hypertrophy, Left Ventricular - diagnostic imaging; Hypertrophy, Left Ventricular - epidemiology; Hypertrophy, Left Ventricular - therapy; Ischemic Attack, Transient - diagnosis; Ischemic Attack, Transient - epidemiology; Ischemic Attack, Transient - therapy; ischemic stroke; left ventricular hypertrophy; Male; Middle Aged; Neurology; Predictive Value of Tests; Prevalence; Retrospective Studies; Risk Factors; secondary prevention; Spain - epidemiology; Stroke - diagnosis; Stroke - epidemiology; Stroke - therapy; Time Factors; transient ischemic attack; Ultrasonography
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2011.03.012

Background Hypertensive left ventricular hypertrophy (HLVH) is a major risk factor for cardiovascular morbidity, mortality, and stroke. However, little is known about the importance of transthoracic echocardiography (TTE) in the assessment of HLVH in patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA). Methods We studied 203 consecutive patients admitted to our hospital with AIS or TIA and who were referred for TTE over the last 4 years. We included 102 (50.2%) lacunar strokes, 76 (37.1%) nonlacunar strokes, and 25 (12.3%) TIAs. The mean age was 68.9 years (standard deviation ±11) and 128 patients were male (63.1%). Results Hypertension was the most common risk factor (131 patients; 64.5%). HLVH was seen in 86 cases (42.3%), in 51.9% of patients with previous hypertension, and in 25% of patients without known hypertension. We found that neither stroke subtype nor any previous risk factor, with the exception of hypertension ( P = .0001), were associated with HLVH. Patients with HLVH were younger (67 v 71 yrs; P  = .013) and more frequently women (50.6% v 37.5%; P = .078). At discharge, patients with HLVH were more likely to receive antihypertensive treatment (97% v 80%; P = .009) and a higher average number of antihypertensive drugs (2.2 v 1.4; P = .0001). Conclusions HLVH was common in patients with AIS or TIA. These individuals had an increased risk of stroke and needed a more intensive therapy. TTE should be carried out in all AIS and TIA patients in order to optimize the management of these patients.