Correlation of echocardiographic findings with cerebral infarction in elderly adults: the AGES-Reykjavik study.
OBJECTIVE
Chronic effects of hypertension may be observed in multiple end organs. Previous reports suggest that cardiovascular morphological features can mirror cerebral infarction. In this cross-sectional analysis of elderly subjects, we investigated the relationship of a comprehensive set of echocardiographic measures with cerebral infarction detected by MRI.


METHODS
We compared echocardiographically determined left ventricular (LV) mass, left atrial volume, aortic root diameter, mitral annular calcification, and measures of diastolic function with cerebral infarction determined by MRI using logistic regression in a random sample drawn from the Age Gene/Environment Susceptibility-Reykjavik Study cohort. The model was first adjusted for age and gender, and then for age, gender, and vascular risk factors.


RESULTS
Among 692 subjects aged 75 (standard deviation, 6) years, 28% had at least 1 cerebral infarct. When adjusted for age and gender, the presence of cerebral infarction was modestly related to LV mass (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.00-1.02) and left atrial volume (OR, 1.03; 95% CI, 1.01-1.05), as well as the lowest quartile of early-to-late pulsed Doppler velocity ratio (early-to-late pulsed Doppler velocity ratio <0.75; OR, 1.87; 95% CI, 1.22-2.87). The latter relation remained significant after adjustment for vascular risk factors and LV ejection fraction (OR, 1.82; 95% CI, 1.16-2.86).


CONCLUSIONS
Of all echocardiographic parameters, LV filling abnormality as indicated by low early-to-late pulsed Doppler velocity ratio displayed the strongest association with cerebral infarction and this relationship was independent of vascular risk factors. This simple marker of cerebral infarction may be useful when evaluating older patients.
McAreavey
Dorothea
D
NIH Clinical Center, National Institutes of Health, Bethesda, Md, USA. dmcareavey@cc.nih.gov
Vidal
Jean-Sébastien
JS
Aspelund
Thor
T
Owens
David S
DS
Hughes
Timothy
T
Garcia
Melissa
M
Sigurdsson
Sigurdur
S
Bjornsdottir
Halldora
H
Harris
Tamara B
TB
Gudnason
Vilmundur
V
Launer
Lenore J
LJ
Plehn
Jonathan F
JF
D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D002544:Cerebral Infarction / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging*; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*
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