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Left ventricular hypertrophy is associated with cerebral microbleeds in hypertensive patients

From the Department of Neurology (Drs. Lee, Park, Kwon, Roh, and Yoon), Department of Epidemiology and Biostatistics and Institute of Public Health (Drs. H. Kim and Y.-H. Kim), School of Public Health, and Neuroscience Research Institute (Drs. Lee, Park, Kwon, Roh, and Yoon), SNUMRC and Clinical Research Institute, Seoul National University Hospital, Republic of Korea.

Address correspondence and reprint requests to Dr. B.-W.Yoon, Department of Neurology, Seoul National University Hospital, 28 Yongon-dong, Jongno-gu, Seoul, 110-744, Republic of Korea; e-mail: bwyoon{at}snu.ac.kr

Background: Cerebral microbleeds (CMBs) are indicative of hemorrhage-prone microangiopathy and known to be closely associated with chronic hypertension. However, no studies have been undertaken on the association between left ventricular (LV) hypertrophy and the severity of CMB.

Methods: One hundred two consecutive stroke patients with hypertension were examined. CMBs were counted using T2*-weighted gradient echo MRI data. With use of ordinal logistic regression analysis, the associations between LV mass index and other vascular risk factors and CMBs were analyzed.

Results: Hypertensive patients with CMBs showed a higher LV mass index than patients without. The grades of LV mass index were significantly correlated with the grades of CMB in the whole brain (p = 0.02), in the central gray matter (p < 0.01), and in the infratentorial area (p < 0.01), but not with those in the subcortical white matter. Ordinal regression analysis revealed that the LV mass index was independently associated with increased CMB severity (p = 0.01), regionally in the central gray matter (p < 0.01) and in the infratentorial area (p < 0.01), but not in the subcortical white matter (p = 0.63). After excluding patients with cerebral amyloid angiopathy, the association between the LV mass index and the CMB severity in the subcortical white matter became significant (p < 0.01).

Conclusions: There is a close relationship between CMBs and LV hypertrophy in hypertensive patients with stroke. Thus, CMBs should be understood as one type of cerebral target organ damage by chronic hypertension.

Received October 12, 2003. Accepted in final form March 11, 2004.

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