Abstract TP200: African American Young Adults with Ischemic Stroke Have High Rates of Left Ventricular Hypertrophy

Introduction: It is well known that African Americans (Afr-Am) have a higher prevalence of hypertension (HTN) compared to Whites. Few studies have compared Afr-Am and Whites for the prevalence of left ventricular hypertrophy (LVH; a marker of long-standing hypertension) in young ischemic stroke patients with and without a history of hypertension to assess hypertension severity and undiagnosed longstanding hypertension. We hypothesized that the prevalence of LVH by echocardiography would be higher in Afr-Am than in their White counterparts. Methods: We identified 1033 patients from a population-based case control study of young patients with first-time ischemic stroke (age 18 to 49 years old, enrolled from 1992-2006) from the Baltimore-Washington area. Patients (n=191, 16%) without an echocardiogram were excluded yielding an analysis sample of 842. Prevalence of LVH by echocardiography (Echo-LVH) were determined in those with and without a history of HTN, stratified by sex and race. Age-adjusted odds ratios and 95% confidence intervals comparing Afr-Am and Whites for the prevalence of Echo-LVH were calculated by logistic regression. Results: Of the 842 young stroke patients included in this study, the median age was 43.0, 55.2% were men, and 48.7 % were Afr-Am. Echo-LVH was common in young patients with ischemic stroke, even patients without a prior history of hypertension. Afr-Am women, both with and without a history of HTN, had higher age-adjusted prevalence of LVH than White women. Afr-Am men with no history of HTN had higher age-adjusted prevalence of Echo-LVH than White men. Afr-Am men with history of HTN had the highest prevalence of LVH, but the age-adjusted comparison with White men with HTN did not achieve statistical significance. Conclusions: The evidence suggests that Afr-Am have greater end organ damage from HTN, even among those who do not have an established diagnosis of HTN. These findings emphasize the need for earlier screening and treatment of HTN in young Afr-Am adults.

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442: Arterial stiffness is associated with left ventricular hypertrophy among ischemic stroke patients

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2007.07.053 ◽

2008 ◽

Vol 15 (3) ◽

pp. 356

Author(s):

Deidre A. De Silva ◽

Fung Peng Woon ◽

Christopher P.L.H. Chen ◽

Hui Meng Chang ◽

Tian Hai Koh ◽

...

Keyword(s):

Ischemic Stroke ◽

Arterial Stiffness ◽

Left Ventricular Hypertrophy ◽

Ventricular Hypertrophy ◽

Left Ventricular ◽

Stroke Patients

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Similarities and Differences in Epidemiology and Risk Factors of Cerebral and Myocardial Ischemic Disease

Serbian Journal of Experimental and Clinical Research ◽

10.1515/sjecr-2017-0045 ◽

2017 ◽

Vol 18 (s1) ◽

pp. 75-80

Author(s):

Angelina Stevanovic ◽

Danijela Tasic ◽

Nebojsa Tasic ◽

Dalibor Dragisic ◽

Miroslav Mitrovic ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Myocardial Infarction ◽

Blood Pressure ◽

Ischemic Stroke ◽

Alcohol Consumption ◽

Left Ventricular Hypertrophy ◽

Ventricular Hypertrophy ◽

Left Ventricular ◽

History Of

Abstract Ischemic heart disease and cerebral ischemia represent the leading causes of mortality worldwide. Both entities share risk factors, pathophisiology and etiologic aspects by means of a main common mechanism, atherosclerosis. The autors aimed to investigate differences and similarities in epidemiology and risk factors that could be found between both entities. In a retrospective sudy 403 patients were included and divided into two groups: group of 289 patients with history of myocardial infarction (AMI), and group of 114 patients with history of ischemic stroke (IS). All patients were evaluated for nonmodifiable risk faktors, which included age and sex, and modifiable, such as hypertension, dyslipidemia, diabetes, obesity, physical activity and smoking. Diff erences in some epidemiological aspects were also considered: occupation, marital status, alcohol consumption, exposure to stress. Patients with history of IS were significantly older then AMI patients (64.0 ± 9.9 vs 64.0 ± 9.9, p=0,028), with higher diastolic blood pressure (87,1 ± 10,2 vs 83,6 ± 10,4, p=0,003) and higher Sokolow-Lyon index in ECG, an also index of left ventricular hypertrophy (19,2 ± 9,1 vs 14,7 ± 6,5). Th ere were no significant differences between groups in the estimated body mass index and waist circumference. Differences between groups in stress exposure, occupation, alcohol consumption or physical activity were no significant. Patients in AMI group were more frequently male (199 (69%) vs 59 (52%), p=0,001), married (252 (87%) vs 88 (77%), p=0,037), smokers (162 (56%) vs 50 (44%), p=0,018) and with higher incidence od dyslipidemia (217 (75%) vs 73 (64%), p=0,019) compared with IS group. Incidence of arterial hypertension and diabetes was similar in both groups. Both entities share similar pathophysiological mechanisms and, consequently, main traditional risk factors. However, incidence of myocardial infarction increases with male sex, dyslipidemia, smoking and marital status, while incidense of ischemic stroke increases with age, higher diastolic blood pressure and also with ECG signs of left ventricular hypertrophy.

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Left ventricular hypertrophy in acute stroke patients with known hypertension

Clinical and Experimental Hypertension ◽

10.1080/10641963.2016.1259328 ◽

2017 ◽

Vol 39 (6) ◽

pp. 502-504 ◽

Cited By ~ 5

Author(s):

Askiel Bruno ◽

Desiree D. Brooks ◽

Taryn A. Abrams ◽

Mitra D. Poorak ◽

Drew Gunio ◽

...

Keyword(s):

Left Ventricular Hypertrophy ◽

Acute Stroke ◽

Ventricular Hypertrophy ◽

Left Ventricular ◽

Stroke Patients

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Natural history of left ventricular hypertrophy in infants of diabetic mothers

International Journal of Cardiology ◽

10.1016/j.ijcard.2021.12.043 ◽

2021 ◽

Author(s):

Emanuele Monda ◽

Federica Verrillo ◽

Ippolita Altobelli ◽

Michele Lioncino ◽

Martina Caiazza ◽

...

Keyword(s):

Natural History ◽

Left Ventricular Hypertrophy ◽

Ventricular Hypertrophy ◽

Left Ventricular ◽

Infants Of Diabetic Mothers ◽

History Of ◽

Diabetic Mothers

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Clinical Characteristics Associated with Electrocardiographic Left Ventricular Hypertrophy in Clinical Normotensives without a History of Hypertension: a Cross-Sectional Study

Korean Journal of Family Medicine ◽

10.4082/kjfm.17.0069 ◽

2019 ◽

Vol 40 (2) ◽

pp. 106-115

Author(s):

Hyoeun Lee ◽

Hong Ji Song ◽

Yu-Jin Paek ◽

Kyung-Hee Park ◽

Hye-Mi Noh ◽

...

Keyword(s):

Left Ventricular Hypertrophy ◽

Clinical Characteristics ◽

Ventricular Hypertrophy ◽

Cross Sectional Study ◽

Left Ventricular ◽

Sectional Study ◽

Cross Sectional ◽

History Of

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Abstract 4130: Applicability Of Left Ventricular Hypertrophy Electrocardiographic Criteria In Professional Athletes

Circulation ◽

10.1161/circ.118.suppl_18.s_835-b ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Nelson Samesima ◽

Carlos A Pastore ◽

Luciana D de Matos ◽

Fernanda F Fumagalli ◽

Mariane V Ferreira ◽

...

Keyword(s):

Left Ventricular Hypertrophy ◽

Ventricular Hypertrophy ◽

Statistical Significance ◽

False Negative ◽

Left Ventricular ◽

False Positives ◽

Professional Athletes ◽

Categorical Variables ◽

S Wave ◽

S Waves

Introduction. The widely known electrocardiographic criteria for diagnosing left ventricular hypertrophy (LVH) use QRS complex voltages to define whether there is left ventricle enlargement or not. Mild myocardial hypertrophy is detected in many professional athletes and this is a consequence of their daily intensity of training. Thus it is not unusual that athlete’s ECGs show large QRS voltages with normal hearts. Objective. To evaluate the applicability of the usual electrocardiographic criteria for LVH - Sokolow-Lyon, Romhilt-Estes, Cornell and Gubner - in a population of professional athletes. Methods. The four LVH criteria for diagnosing LVH were applied to analyse ECGs of 107 professional athletes (71% soccer players, 29% marathonists, all male, age 25± 10 years, training for 9± 8 years) by the same observer unaware of echocardiographic results. ECG was considered to be indicative of LVH if: Sokolow-Lyon ≥35mm (V 1or 2 S wave+V 5or 6 R wave); Romhilt-Estes score ≥5 points (frontal plane: R or S waves ≥ 20mm, horizontal plane: R or S waves ≥ 30mm, Morris indices, V 5or 6 strain pattern, left axis deviation ≥ − 30°, intrinsecoid deflection ≥ 0.04s, QRS duration ≥ 0.10s) ; Cornell ≥ 28mm (aV L R wave + V 3 S wave); Gubner ≥ 22mm (D I R wave + D III S wave). Hypertrophy was considered whenever: LV diastolic diameter ≥ 60mm and/or septum ≥ 13mm and/or LV posterior wall ≥ 13mm. Kruskal-Wallis was used to statistically analyse quantitative variables, corrected chi-square test for categorical variables. Significance level: p ≤ 0.05. Results. Romhilt-Estes showed the best results (75% sensitivity, 84% specificity, 16 false-positives, 1 false-negative), and was the only criteria with statistical significance (p = 0.047). Sokolow-Lyon showed 100% sensitivity, 15% specificity, p = 0.545, 88% false-positives, 0% false-negative. Cornell and Gubner showed 25% and 0% sensitivity, 95% and 99% specificity, p=0.205 and p = 0.449, respectively. Conclusion. In this male population of professional athletes, Romhilt-Estes score proved to be the best criterion for identifying left ventricular hypertrophy, while Sokolow-Lyon criterion did not discriminate normal from abnormal hearts. Cornell and Gubner criteria should not be used in this population because of their low sensitivity.

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