title: Hemorrhagic transformation of acute ischemic stroke is limited in hypertensive patients with cardiac hypertrophy.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Angiocardioneurology and Translational Medicine, IRCCS Neuromed, 86077 Pozzilli, IS, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Landolfi
authors.affiliation: Department of Angiocardioneurology and Translational Medicine, IRCCS Neuromed, 86077 Pozzilli, IS, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Selvetella
authors.affiliation: Department of Angiocardioneurology and Translational Medicine, IRCCS Neuromed, 86077 Pozzilli, IS, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Cugino
authors.affiliation: UOC Neuroradiology, Diagnostic and Therapeutics, IRCCS Neuromed, Pozzilli, IS, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Grillea
authors.affiliation: Department of Angiocardioneurology and Translational Medicine, IRCCS Neuromed, 86077 Pozzilli, IS, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Maffei
authors.affiliation: Department of Angiocardioneurology and Translational Medicine, IRCCS Neuromed, 86077 Pozzilli, IS, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Notte
authors.affiliation: 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.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lembo
authors.affiliation: 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.
authors.forename: Daniela
authors.initials: D
authors.lastname: Carnevale
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006332:Cardiomegaly / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016037:Single-Blind Method; D020521:Stroke / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015898:Tomography Scanners, X-Ray Computed
keywords: Cardiac hypertrophy; Hemorrhagic transformation; Hypertension; Stroke