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ISRN Stroke  2013 

The Impact of Left Ventricular Hypertrophy and Diastolic Dysfunction on Outcome in Intracerebral Hemorrhage Patients

DOI: 10.1155/2013/898163

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Abstract:

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 [3–6]. 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—hypertension (HTN). The majority of hypertensive intracerebral hemorrhages are located in deep supratentorial regions [8–13]. 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%–41% [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

References

[1]  L. R. Caplan, “Intracerebral haemorrhage,” The Lancet, vol. 339, no. 8794, pp. 656–658, 1992.
[2]  J. P. Broderick, T. Brott, T. Tomsick, R. Miller, and G. Huster, “Intracerebral hemorrhage more than twice as common as subarachnoid hemorrhage,” Journal of Neurosurgery, vol. 78, no. 2, pp. 188–191, 1993.
[3]  J. Broderick, T. Brott, T. Tomsick et al., “Management of intracerebral hemorrhage in a large metropolitan population,” Neurosurgery, vol. 34, no. 5, pp. 882–887, 1994.
[4]  M. S. Dennis, “Outcome after brain haemorrhage,” Cerebrovascular Diseases, vol. 16, supplement 1, pp. 9–13, 2003.
[5]  M. L. Flaherty, M. Haverbusch, P. Sekar et al., “Long-term mortality after intracerebral hemorrhage,” Neurology, vol. 66, no. 8, pp. 1182–1186, 2006.
[6]  R. Fogelholm, K. Murros, A. Rissanen, and S. Avikainen, “Long term survival after primary intracerebral haemorrhage: a retrospective population based study,” Journal of Neurology, Neurosurgery and Psychiatry, vol. 76, no. 11, pp. 1534–1538, 2005.
[7]  D. Woo, L. R. Sauerbeck, B. M. Kissela et al., “Genetic and environmental risk factors for intracerebral hemorrhage: preliminary results of a population-based study,” Stroke, vol. 33, no. 5, pp. 1190–1195, 2002.
[8]  M. L. Flaherty, D. Woo, M. Haverbusch et al., “Racial variations in location and risk of intracerebral hemorrhage,” Stroke, vol. 36, no. 5, pp. 934–937, 2005.
[9]  O. G. Nilsson, A. Lindgren, N. St?hl, L. Brandt, and H. S?veland, “Incidence of intracerebral and subarachnoid haemorrhage in southern Sweden,” Journal of Neurology Neurosurgery and Psychiatry, vol. 69, no. 5, pp. 601–607, 2000.
[10]  T. Inagawa, N. Ohbayashi, A. Takechi et al., “Primary intracerebral hemorrhage in Izumo City, Japan: incidence rates and outcome in relation to the site of hemorrhage,” Neurosurgery, vol. 53, no. 6, pp. 1283–1298, 2003.
[11]  C. S. Anderson, T. M. H. Chakera, E. G. Stewart-Wynne, and K. D. Jamrozik, “Spectrum of primary intracerebral haemorrhage in Perth, Western Australia, 1989-90: incidence and outcome,” Journal of Neurology Neurosurgery and Psychiatry, vol. 57, no. 8, pp. 936–940, 1994.
[12]  R. Fogelholm, M. Nuutila, and A.-L. Vuorela, “Primary intracerebral haemorrhage in the Jyvaskyla region, Central Finland, 1985-89: incidence, case fatality rate, and functional outcome,” Journal of Neurology Neurosurgery and Psychiatry, vol. 55, no. 7, pp. 546–552, 1992.
[13]  M. Giroud, C. Milan, P. Beuriat et al., “Incidence and survival rates during a two-year period of intracerebral and subarachnoid haemorrhages, cortical infarcts, lacunes and transient ischaemic attacks. The stroke registry of Dijon: 1985–1989,” International Journal of Epidemiology, vol. 20, no. 4, pp. 892–899, 1991.
[14]  W. B. Kannel, T. R. Dawber, and P. M. McNamara, “Vascular disease of the brain—epidemiologic aspects: The Framingham Study,” American Journal of Public Health and the Nation's Health, vol. 55, pp. 1355–1366, 1965.
[15]  C. Cuspidi, C. Sala, F. Negri, G. Mancia, and A. Morganti, “Prevalence of left-ventricular hypertrophy in hypertension: an updated review of echocardiographic studies,” Journal of Human Hypertension, vol. 26, pp. 343–349, 2012.
[16]  C. Cuspidi, A. Vaccarella, F. Negri, and C. Sala, “Resistant hypertension and left ventricular hypertrophy: an overview,” Journal of the American Society of Hypertension, vol. 4, no. 6, pp. 319–324, 2010.
[17]  M. J. Koren, R. B. Devereux, P. N. Casale, D. D. Savage, and J. H. Laragh, “Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension,” Annals of Internal Medicine, vol. 114, no. 5, pp. 345–352, 1991.
[18]  G. A. Mensah, T. W. Pappas, M. J. Koren, R. J. Ulin, J. H. Laragh, and R. B. Devereux, “Comparison of classification of the severity of hypertension by blood pressure level and by World Health Organization criteria in the prediction of concurrent cardiac abnormalities and subsequent complications in essential hypertension,” Journal of Hypertension, vol. 11, no. 12, pp. 1429–1440, 1993.
[19]  D. Levy, R. J. Garrison, D. D. Savage, W. B. Kannel, and W. P. Castelli, “Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study,” The New England Journal of Medicine, vol. 322, no. 22, pp. 1561–1566, 1990.
[20]  K. Albright, A. Aysenne, T. Chang, et al., “The role of echocardiography in intracerebral hemorrhage,” in Proceedings of the 3rd International Conference on Intracerebral Hemorrhage, Palm Springs, Calif, USA, 2010.
[21]  S. Martin-Schild, K. C. Albright, H. Hallevi et al., “Intracerebral hemorrhage in cocaine users,” Stroke, vol. 41, no. 4, pp. 680–684, 2010.
[22]  C. J. Dickinson, “Why are strokes related to hypertension? Classic studies and hypotheses revisited,” Journal of Hypertension, vol. 19, no. 9, pp. 1515–1521, 2001.
[23]  L. B. Morgenstern, J. C. Hemphill III, C. Anderson et al., “Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association,” Stroke, vol. 41, no. 9, pp. 2108–2129, 2010.
[24]  T. Yamazaki', K. Yanaka, and T. Aoki, “Cardiac function estimated by doppler echocardiography in patients with hypertensive intracerebral hemorrhage,” Brain and Nerve, vol. 52, no. 6, pp. 501–505, 2000.
[25]  D. K. Lee, P. R. Marantz, R. B. Devereux, P. Kligfield, and M. H. Alderman, “Left ventricular hypertrophy in black and white hypertensives: standard electrocardiographic criteria overestimate racial differences in prevalence,” Journal of the American Medical Association, vol. 267, no. 24, pp. 3294–3299, 1992.

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