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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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Background and Purpose Left ventricular hypertrophy (LVH) is associated with the risk of stroke and dementia independently of other vascular risk factors, but its association with cerebral small vessel disease (CSVD) remains unknown. Here, we employed a systematic review and meta-analysis to address this gap. Methods Following the MOOSE guidelines (PROSPERO protocol: CRD42018110305), we systematically searched the literature for studies exploring the association between LVH or left ventricular (LV) mass, with neuroimaging markers of CSVD (lacunes, white matter hyperintensities [WMHs], cerebral microbleeds [CMBs]). We evaluated risk of bias and pooled association estimates with random-effects meta-analyses. Results We identified 31 studies (n=25,562) meeting our eligibility criteria. In meta-analysis, LVH was associated with lacunes and extensive WMHs in studies of the general population (odds ratio [OR]lacunes, 1.49; 95% confidence interval [CI], 1.12 to 2.00) (ORWMH, 1.73; 95% CI, 1.38 to 2.17) and studies in highrisk populations (ORlacunes: 2.39; 95% CI, 1.32 to 4.32) (ORWMH, 2.01; 95% CI, 1.45 to 2.80). The results remained stable in general population studies adjusting for hypertension and other vascular risk factors, as well as in sub-analyses by LVH assessment method (echocardiography/electrocardiogram), study design (cross-sectional/cohort), and study quality. Across LV morphology patterns, we found gradually increasing ORs for concentric remodelling, eccentric hypertrophy, and concentric hypertrophy, as compared to normal LV geometry. LVH was further associated with CMBs in high-risk population studies. Conclusions LVH is associated with neuroimaging markers of CSVD independently of hypertension and other vascular risk factors. Our findings suggest LVH as a novel risk factor for CSVD and highlight the link between subclinical heart and brain damage.
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참고문헌 (94)
참고문헌 신청
Pantoni L / 2010 / Cerebral small vessel disease : from pathogenesis and clinical characteristics to therapeutic challenges / Lancet Neurol 9:689~701
Wardlaw JM / 2019 / Small vessel disease : mechanisms and clinical implications / Lancet Neurol 18:684~696
Dichgans M / 2017 / Vascular cognitive impairment / Circ Res 120:573~591
Sudlow CL / 1997 / Comparable studies of the incidence of stroke and its pathological types: results from an international collaboration. International Stroke Incidence Collaboration / Stroke 28:491~499
Qureshi AI / 2001 / Spontaneous intracerebral hemorrhage / N Engl J Med 344:1450~1460
Wardlaw JM / 2019 / Small vessel disease : mechanisms and clinical implications / Lancet Neurol 18:684~696
Dichgans M / 2017 / Vascular cognitive impairment / Circ Res 120:573~591
Sudlow CL / 1997 / Comparable studies of the incidence of stroke and its pathological types: results from an international collaboration. International Stroke Incidence Collaboration / Stroke 28:491~499
Qureshi AI / 2001 / Spontaneous intracerebral hemorrhage / N Engl J Med 344:1450~1460
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