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Echocardiographic left ventricular mass index predicts incident stroke in African Americans: Atherosclerosis Risk in Communities (ARIC) Study.

TitleEchocardiographic left ventricular mass index predicts incident stroke in African Americans: Atherosclerosis Risk in Communities (ARIC) Study.
Publication TypeJournal Article
Year of Publication2007
AuthorsFox ER, Alnabhan N, Penman AD, Butler KR, Taylor HA, Skelton TN, Mosley TH
JournalStroke
Volume38
Issue10
Pagination2686-91
Date Published2007 Oct
ISSN1524-4628
KeywordsAfrican Americans, Cohort Studies, Echocardiography, Female, Follow-Up Studies, Humans, Hypertrophy, Left Ventricular, Incidence, Intracranial Arteriosclerosis, Male, Middle Aged, Multivariate Analysis, Predictive Value of Tests, Proportional Hazards Models, Risk Factors, Stroke
Abstract

BACKGROUND AND PURPOSE: Despite theories that link stroke to left ventricular mass, few large, population-based studies have examined the predictive value of echocardiographically derived left ventricular mass index (LVMI) to incident stroke in African Americans.

METHODS: Participants in the Jackson cohort of the Atherosclerotic Risk in Communities study have had extensive baseline evaluations, have undergone echocardiography during the third examination (1993-1995), and have been followed up for incident cardiovascular disease including ischemic stroke.

RESULTS: The study population consisted of 1792 participants, of whom 639 (35.7%) were men and the mean+/-SD age was 58.8+/-5.7 years. Compared with those without ischemic stroke, those with ischemic stroke had a higher frequency of hypertension (85.6% vs 58.7%) and diabetes (46.9% vs 21.0%). Left ventricular hypertrophy was more prevalent in those with stroke (62.2% vs 38.6%). During a median follow-up of 8.8 years, 98 incident strokes occurred (6.5 per 1000 person-years). LVMI was independently associated with stroke after adjusting for age, sex, hypertension, systolic blood pressure, smoking, diabetes, total to HDL cholesterol ratio, body mass index, and low left ventricular ejection fraction (adjusted hazard ratio per 10 g/m(2.7) increment of LVMI=1.15; 95% CI, 1.02 to 1.28). The relation remained statistically significant after adding left atrial size and mitral annular calcification to the multivariable model.

CONCLUSIONS: In this large, population-based African American cohort, we found that echocardiographic LVMI was an independent predictor of incident ischemic stroke even after taking into account traditional clinical risk factors.

DOI10.1161/STROKEAHA.107.485425
Alternate JournalStroke
PubMed ID17761924
PubMed Central IDPMC3292849
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
N01 HC095170 / HC / NHLBI NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01 HC055018 / HC / NHLBI NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
N01 HC095171 / HC / NHLBI NIH HHS / United States
N01 HC055019 / HC / NHLBI NIH HHS / United States
N01HC95170 / HL / NHLBI NIH HHS / United States
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
N01 HC055015 / HC / NHLBI NIH HHS / United States
N01-HC-95171 / HC / NHLBI NIH HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
N01-HC-95172 / HC / NHLBI NIH HHS / United States
N01HC95171 / HL / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States
N01-HC-95170 / HC / NHLBI NIH HHS / United States
N01 HC055016 / HC / NHLBI NIH HHS / United States
N01HC95172 / HL / NHLBI NIH HHS / United States