The Relationship Of Left Ventricular Geometry And Leukoaraiosis In Patients With First-ever Ischemic Stroke

Objective:Left ventricular remodeling can be clinically defined as changes in the size,shape and function of the heart after cardiac injury.Adverse loading conditions and cardiac injury lead to remodeling of the heart into different patterns of left ventricular(LV)geometry.Left ventricular geometry was divided into 4 patterns by echocardiography,This paper evaluates the relationship of Left ventricular geometry,age or hypertension and the severity degree of leukoaraiosis among the patients who diagnosed as first-ever ischemic strokeMethods:1.243 patients who diagnosed as first-ever ischemic stroke were admitted in department of neurology in Fujian Medical University Union Hospital continuously from January 2017 to January 2018.And gathering their clinical information such as general information,biochemical markers,brain MRI data and Echocardiography data.2.According to the absence of LA,the patients were divided into non-LA group(Fazekas score≤2)and LA group(Fazekas score≥3),The clinical information including general information,biochemical makers and index of Echocardiography etc,were compared between these two groups,finally analyze independent relevant factors of LA.The date was analyzed by using univariate analysis and logistic repression analysis.3.Four left ventricular patterns(normal geometric,concentric hypertrophy,concentric remodeling and eccentric hypertrophy)are identified by echocar-diography.The clinical information including general information,biochemical makers and data about Leukoaraiosis etc,were compared between these four groups.The date was analyzed by using univariate analysis.4.Take normal geometric as reference,analysis the relationship of there abnormal left ventricular geometry and leukoaraiosis in Patients with First-ever Ischemic Stroke.5.According to the distribution of LA,the patients were divided into the lateral ventricle LA(Single Fazekas score≥2)and deep white matter LA(Single Fazekas score≥2),analysis the relationship of there abnormal left ventricular geometry with these two groups.Result:1.Univariate analysis showed that there were significant difference in age,drinking,HCY,coronary heart disease,hypertension disease,intima-media thickness and left ventricular hypertrophy between non-LA group and LA group.(P<0.05)2.Univariate analysis showed that there were significant difference in LVPW,LAD,IVST between non-LA group and LA group(P<0.05).3.Logistic-regression analysis showed that compared to the non-LA group,age,drinking,intima-media thicknessand left ventricular hypertrophy were Statistically associated with LA(P<0.05),except HCY,coronary heart disease,hypertension disease,LVPW,LAD and IVST.4.The left ventricle was divided into 4 configurations according to LVMI and RWT.Univariate analysis showed that there were significant difference in hypertension disease,HCY,intima-media thickness,LA,and the Fazekas score of the lateral ventricle LA and deep white matter LA between four groups.5.Take normal geometric as reference,in the unadjusted model,three abnormal left ventricular configurations(CR,CH,EH)were significant associated with leukoaraiosis(OR:2.524、6.111、6.471 P<0.05)After adjusting for possible confounding factors,patients with CH carried the graetest risk for LA,followed by patienets with EH,but not patients with CR.(OR:1.685、2.306 P<0.05)6.According to the distribution of LA,the patients were divided into the lateral ventricle LA(Single Fazekas score≥2)and deep white matter LA(Single Fazekas score≥2),Take normal geometric as reference,in the unadjusted model,three abnormal left ventricular configurations(CR,CH,EH)were significant associated with the lateral ventricle LA and deep white matter LA(P < 0.05)After adjusting for possible confounding factors,patients with CH carried the graetest risk for the lateral ventricle LA and deep white matter LA,followed by patienets with EH,but not patients with CR.(OR:1.517、2.166 P<0.05 OR:1.605、3.006 P<0.05)Conclusion: 1.In patients with first-ever ischemic stroke,age,intima-media thickness and left ventricular hypertrophy are independent risk factor of LA.HCY,coronary heart disease,hypertension disease,LVPW,LAD and IVST are not independent risk factor for LA.2.In patients with first-ever ischemic stroke,Take normal geometric as reference,patients with CH carried the graetest risk for different part of LA,followed by patienets with EH,but not patients with CR.3.LVH may lead to the development of LA mainly by reducing the mechanism of cerebral blood flow perfusion.