Alessandro Landolfi1, Giulio Selvetella1, Daniela Cugino1, Giovanni Grillea2, Angelo Maffei1, Antonella Notte1, Giuseppe Lembo3, Daniela Carnevale4. 1. Department of Angiocardioneurology and Translational Medicine, IRCCS Neuromed, 86077 Pozzilli, IS, Italy. 2. UOC Neuroradiology, Diagnostic and Therapeutics, IRCCS Neuromed, Pozzilli, IS, Italy. 3. Department of Angiocardioneurology and Translational Medicine, IRCCS Neuromed, 86077 Pozzilli, IS, Italy; Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy. Electronic address: lembo@neuromed.it. 4. Department of Angiocardioneurology and Translational Medicine, IRCCS Neuromed, 86077 Pozzilli, IS, Italy; Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy. Electronic address: daniela.carnevale@neuromed.it.
Abstract
BACKGROUND: It has been clearly demonstrated that hypertension and one of its main evoked effects, cardiac hypertrophy, are independent risk factors for ischemic stroke. However, the ischemic brain lesions can further be affected by a second wave of injury characterized by hemorrhagic transformation (HT) of the primary ischemic lesion, which significantly aggravates the clinical outcome. So far, the risk factors that could affect such a transition in hypertensive patients are still unclear. METHODS: In this study, we investigated whether in hypertensive patients the concomitant presence of cardiac hypertrophy can affect the transition of ischemic brain lesions toward HT. RESULTS: Our analysis was focused on a population of hypertensive patients admitted to our Acute Stroke Unit. The hypertensives with acute ischemic stroke suffering of HT were 18% of the sample. In these latter, the prevalence of cardiac hypertrophy was significantly lower than in those spared by HT as also shown by the levels of left ventricular mass index (LVMI) that were significantly higher in patients spared by HT. More important, cardiac hypertrophy was protective even from symptomatic HT. CONCLUSION: Here we show that hypertensive patients with cardiac hypertrophy have less probability to develop HT during an acute episode of ischemic stroke. These results could help to identify patients with lower risk of spontaneous HT and that could have better beneficial effects from thrombolytic therapy during acute ischemic stroke.
BACKGROUND: It has been clearly demonstrated that hypertension and one of its main evoked effects, cardiac hypertrophy, are independent risk factors for ischemic stroke. However, the ischemic brain lesions can further be affected by a second wave of injury characterized by hemorrhagic transformation (HT) of the primary ischemic lesion, which significantly aggravates the clinical outcome. So far, the risk factors that could affect such a transition in hypertensivepatients are still unclear. METHODS: In this study, we investigated whether in hypertensivepatients the concomitant presence of cardiac hypertrophy can affect the transition of ischemic brain lesions toward HT. RESULTS: Our analysis was focused on a population of hypertensivepatients admitted to our Acute Stroke Unit. The hypertensives with acute ischemic stroke suffering of HT were 18% of the sample. In these latter, the prevalence of cardiac hypertrophy was significantly lower than in those spared by HT as also shown by the levels of left ventricular mass index (LVMI) that were significantly higher in patients spared by HT. More important, cardiac hypertrophy was protective even from symptomatic HT. CONCLUSION: Here we show that hypertensivepatients with cardiac hypertrophy have less probability to develop HT during an acute episode of ischemic stroke. These results could help to identify patients with lower risk of spontaneous HT and that could have better beneficial effects from thrombolytic therapy during acute ischemic stroke.
Authors: Qiong Wang; Jenna M Reps; Kristin Feeney Kostka; Patrick B Ryan; Yuhui Zou; Erica A Voss; Peter R Rijnbeek; RuiJun Chen; Gowtham A Rao; Henry Morgan Stewart; Andrew E Williams; Ross D Williams; Mui Van Zandt; Thomas Falconer; Margarita Fernandez-Chas; Rohit Vashisht; Stephen R Pfohl; Nigam H Shah; Suranga N Kasthurirathne; Seng Chan You; Qing Jiang; Christian Reich; Yi Zhou Journal: PLoS One Date: 2020-01-07 Impact factor: 3.240