%0 Journal Article
%T The Impact of Left Ventricular Hypertrophy and Diastolic Dysfunction on Outcome in Intracerebral Hemorrhage Patients
%A Karen C. Albright
%A Joshua M. Burak
%A Tiffany R. Chang
%A Aimee Aysenne
%A James E. Siegler
%A Laurie Schluter
%A Sharyl R. Martini
%A Amelia K. Boehme
%A Sheryl Martin-Schild
%J ISRN Stroke
%D 2013
%R 10.1155/2013/898163
%X Background. The objective of this study was to determine the prevalence of LVH and DD in patients presenting with supratentorial deep ICH and to determine if the presence of LVH or DD was an independent predictor of initial ICH volume, hematoma expansion, or poor outcome. Methods. A cross-sectional study was performed on ICH patients who presented from 7/2008 to 12/2010. Cases were excluded if ICH was traumatic, lobar, infratentorial, secondary to elevated international normalized ratio, suspicious for underlying structural malformation, or where surgical evacuation was performed. Logistic and linear regressions were used to assess the ability of LVH to predict ICH imaging characteristics and patient outcomes. Results. After adjusting for use of hemostatic agents, LVH was not a significant independent predictor of initial ICH volume or 33% volume expansion . After adjusting for age, infectious complications, and use of hemostatic agents, LVH was not a significant independent predictor of poor functional outcome . Similar results were seen for DD. Conclusion. In our sample, patients with deep ICH and LVH were more likely to develop IVH, but LVH was not a significant independent predictor of initial ICH volume, hematoma expansion, or poor short-term outcome. 1. Introduction Intracerebral hemorrhage (ICH) accounts for 10% to 15% of strokes [1, 2]. With an estimated 30-day mortality rate greater than 40% and fewer than 1 in 5 survivors functionally independent at 6 months, ICH is more likely to result in death and disability than ischemic stroke [3¨C6]. Epidemiologic evidence suggests that the pathophysiology of spontaneous ICH differs for lobar and deep ICH [7]. Lobar ICH, frequently seen in the elderly, is often presumed to be the result of amyloid angiopathy, whereas deep ICH, such as this seen in the basal ganglia, is attributed to a modifiable risk factor¡ªhypertension (HTN). The majority of hypertensive intracerebral hemorrhages are located in deep supratentorial regions [8¨C13]. In addition to being the single largest risk factor for ICH, hypertension is the primary risk factor for cardiac disease [14]. Hypertensive end organ damage in the heart (i.e., hypertensive heart disease) is prevalent with reported rates of left ventricular hypertrophy (LVH) in hypertensive patients of 36%¨C41% [15]. In patients with resistant hypertension, these rates range from 55% to 75% [16]. While LVH has been shown to be a significant independent predictor of myocardial infarction, stroke, and cardiovascular death in the general population [17, 18], patients with coronary
%U http://www.hindawi.com/journals/isrn.stroke/2013/898163/