Abstract for presentation at The Australian and New Zealand Association of Neurologists Annual Scientific Meeting 2007

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

  • Dr Deidre De Silva, National Neuroscience Institute, Singapore General Hospital campus, Singapore
  • Fung Peng Woon, National Heart Centre, Singapore
  • A/Prof Christopher Chen, National Medical Research Council, Singapore
  • Dr Hui Meng Chang, National Neuroscience Institute, Singapore General Hospital campus, Singapore
  • A/Prof Tian Hai Koh, National Heart Centre, Singapore
  • A/Prof James Cameron, Monash University, Australia
  • A/Prof Bronwyn Kingwell, Baker Medical Research Institute, Australia
  • A/Prof Meng Cheong Wong, National Neuroscience Institute, Singapore General Hospital campus, Singapore

    • Purpose: Arterial stiffness is a recognized risk factor for atherosclerosis. Left ventricular hypertrophy (LVH) is a marker of cardiac damage, most commonly due to hypertension. Both are known to be associated with higher cardiovascular mortality. Our research group previously demonstrated that hypertension is independently associated with arterial stiffness among ischemic stroke patients. We aimed to study the association of LVH with arterial stiffness among ischemic stroke patients.
    Methods: We studied 331 ethnic Chinese and South Asian patients admitted to the Singapore General Hospital with acute ischemic stroke. Arterial stiffness was measured by central pulse wave velocity (cPWV) determined by applanation tonometry. LVH was defined as R waves>25mm in V5/V6 or (R wave in V5/V6 + S wave in V1/V2)>35mm.
    Results: The patients’ characteristics were median age 62 years, 68% male, 76% Chinese, 24% South Asian, 79% hypertensive, 51% diabetic, 22% with known ischemic heart disease (IHD) and 31% with LVH. Median cPWV was 11.4m/s (range 4.7-19.7).
    As expected we found that cPWV was higher among hypertensives (12.4m/s) than non-hypertensives (10.3m/s) (p<0.001), diabetics (12.6m/s) than non-diabetics (11.3m/s)(p<0.001) and patients with LVH (12.8m/s) than those without (11.6m/s)(p=0.001). There was a significant correlation between increased cPWV and older age (p<0.001). cPWV was not associated with ethnicity (p=0.105), gender (p=0.272) and IHD (p=0.248). In multivariate regression analysis, older age (p<0.001), hypertension (p<0.001), diabetes (p=0.001) or presence of LVH (p=0.028) were independently associated with cPWV.
    Conclusions: We describe a novel association between LVH and arterial stiffness among ischemic stroke patients. Further research is required to uncover the reasons for this association. One possible reason is LVH reflects poor blood pressure control which is involved in the pathogenesis of arterial stiffening. The other possibility is stiff large arteries lead to LVH due to increased cardiac output resistance.

    Conference Organiser - ICMS Pty Ltd