Hemorrhagic transformation of acute ischemic stroke is limited in hypertensive patients with cardiac hypertrophy

Alessandro Landolfi, Giulio Selvetella, Daniela Cugino, Giovanni Grillea, Angelo Maffei, Antonella Notte, Giuseppe Lembo, Daniela Carnevale

Research output: Contribution to journalArticle

1 Citation (Scopus)

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. Conclusion 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.

Original languageEnglish
Pages (from-to)362-366
Number of pages5
JournalInternational Journal of Cardiology
Volume219
DOIs
Publication statusPublished - Sep 15 2016

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Cardiomegaly
Stroke
Thrombolytic Therapy
Brain
Hypertension
Wounds and Injuries
Population

Keywords

  • Cardiac hypertrophy
  • Hemorrhagic transformation
  • Hypertension
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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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. Conclusion 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.",
keywords = "Cardiac hypertrophy, Hemorrhagic transformation, Hypertension, Stroke",
author = "Alessandro Landolfi and Giulio Selvetella and Daniela Cugino and Giovanni Grillea and Angelo Maffei and Antonella Notte and Giuseppe Lembo and Daniela Carnevale",
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T1 - Hemorrhagic transformation of acute ischemic stroke is limited in hypertensive patients with cardiac hypertrophy

AU - Landolfi, Alessandro

AU - Selvetella, Giulio

AU - Cugino, Daniela

AU - Grillea, Giovanni

AU - Maffei, Angelo

AU - Notte, Antonella

AU - Lembo, Giuseppe

AU - Carnevale, Daniela

PY - 2016/9/15

Y1 - 2016/9/15

N2 - 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. Conclusion 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.

AB - 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. Conclusion 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.

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