title: Left ventricular mass-geometry and silent cerebrovascular disease: The Cardiovascular Abnormalities and Brain Lesions (CABL) study.
abstract: BACKGROUND
  Although abnormal left ventricular geometric patterns have prognostic value for morbidity and mortality, their possible association with silent cerebrovascular disease has not been extensively evaluated.
  
  
  METHODS
  We examined 665 participants in the CABL study who underwent transthoracic echocardiography and brain magnetic resonance imaging. Participants were divided into 4 geometric patterns: normal geometry (n=397), concentric remodeling (n=89), eccentric hypertrophy (n=126), and concentric hypertrophy (n=53). Subclinical cerebrovascular disease was defined as silent brain infarcts (SBIs) and white matter hyperintensity volume (WMHV; expressed as log-transformed percentage of the total cranial volume).
  
  
  RESULTS
  Silent brain infarcts were observed in 94 participants (14%). Mean log-WMHV was -0.97±0.93. Concentric hypertrophy carried the greatest risk for both SBI (adjusted odds ratio [OR] 3.39, P<.001) and upper quartile of log-WMHV (adjusted OR 3.35, P<.001), followed by eccentric hypertrophy (adjusted ORs 2.52 [P=.001 for SBI] and 1.96 [P=.004] for log-WMHV). Concentric remodeling was not associated with subclinical brain disease. In subgroup analyses, concentric and eccentric hypertrophies were significantly associated with SBI and WMHV in both genders and nonobese participants, but differed for SBI by age (all ages for eccentric hypertrophy, only patients ≥70years for concentric hypertrophy) and by race-ethnicity (Hispanics for eccentric hypertrophy, blacks for concentric hypertrophy; no association in whites).
  
  
  CONCLUSIONS
  Left ventricular hypertrophy, with both eccentric and concentric patterns, was significantly associated with subclinical cerebrovascular disease in a multiethnic stroke-free general population. Left ventricular geometric patterns may carry different risks for silent cerebrovascular disease in different sex, age, race-ethnic, and body size subgroups.
authors.affiliation: Department of Medicine, Columbia University, New York, NY.
authors.forename: Koki
authors.initials: K
authors.lastname: Nakanishi
authors.affiliation: Department of Biostatistics, Columbia University, New York, NY.
authors.forename: Zhezhen
authors.initials: Z
authors.lastname: Jin
authors.affiliation: Department of Medicine, Columbia University, New York, NY.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Homma
authors.affiliation: Departments of Neurology and Epidemiology, Columbia University, New York, NY.
authors.forename: Mitchell S V
authors.initials: MS
authors.lastname: Elkind
authors.affiliation: Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL; Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Rundek
authors.affiliation: Department of Medicine, Columbia University, New York, NY.
authors.forename: Aylin
authors.initials: A
authors.lastname: Tugcu
authors.affiliation: Department of Neurology, Hokuriku National Hospital, Nanto, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yoshita
authors.affiliation: Department of Neurology, University of California at Davis, Davis, CA.
authors.forename: Charles
authors.initials: C
authors.lastname: DeCarli
authors.affiliation: Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL; Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL.
authors.forename: Clinton B
authors.initials: CB
authors.lastname: Wright
authors.affiliation: Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL; Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL; Department of Human Genetics, Miller School of Medicine, University of Miami, Miami, FL.
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.affiliation: Department of Medicine, Columbia University, New York, NY. Electronic address: md42@cumc.columbia.edu.
authors.forename: Marco R
authors.initials: MR
authors.lastname: Di Tullio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases; D044383:Black People / Q000706:statistics & numerical data; D001921:Brain / Q000000981:diagnostic imaging*; D020520:Brain Infarction / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000453:epidemiology; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000453:epidemiology; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D009929:Organ Size; D020257:Ventricular Remodeling; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American