Abnormal Left Ventricular Geometry is Associated with Cerebral White Matter Disease (S36.005)

Abstract

<h3>Objective:</h3> To evaluate the association between left ventricular (LV) geometry and cerebral white matter disease (WMD). <h3>Background:</h3> WMD is a type of cerebral small vessel disease shown to increase risk of stroke and dementia. Reduced cardiac outflow due to left ventricular hypertrophy has been suggested as a potential risk factor for the development of WMD. The relationship between the LV geometry and the WMD volume has not been well established. <h3>Design/Methods:</h3> Consecutive patients from 2016–2022 who are ≥18 years who underwent an echocardiogram, Cardiac MRI, NT-proBNP test, and a brain MRI within one year were included. Four categories of LV geometry were defined: normal, eccentric hypertrophy, concentric remodeling, and concentric hypertrophy. WMD volume was quantified using an automated algorithm applied to axial T2 FLAIR images. Multivariable regression analyses were performed to evaluate the relationship between LV geometry and WMD volume. <h3>Results:</h3> A total of 112 patients were identified. Mean age was 63 ± 16 years, 48.2% were females, 68.8% had hypertension and 67.9% had coronary heart disease. WMD volume was highest in patients with concentric remodeling (11.34 ± 10.12cc) and concentric hypertrophy (10.08 ± 10.66cc) compared to eccentric hypertrophy (6.39 ± 6.06cc) and normal morphology (5.66 ± 6.74cc) with a trend-P value of 0.028. Patients with relative wall thickness (RWT) &gt;42% had higher WMD volume (10.73 ± 10.29cc vs 5.89 ± 6.46cc, P=0.003), compared to those with RWT≤42%. Patients with fibrosis on cardiac MRI appeared to have higher WMD volume but did not achieve statistical significance (10.30 ± 10.59cc vs 7.41 ± 8.02cc, P=0.144). <h3>Conclusions:</h3> Our results showed that abnormal LV geometry is associated with higher WMD burden. Future studies are needed to explore whether the control of hypertension with specific class of antihypertensive medication may mediate the adverse left ventricular remodeling in slowing WMD progression. <b>Disclosure:</b> Mr. Salem has nothing to disclose. Mr. Mateti has nothing to disclose. Dr. Demirer has nothing to disclose. Dr. Anisetti has nothing to disclose. Mr. Youssef has nothing to disclose. Dr. Elkhair has nothing to disclose. An immediate family member of Demilade Adedinsewo has received personal compensation for serving as an employee of Apple Inc. The institution of Demilade Adedinsewo has received research support from NIH. The institution of Demilade Adedinsewo has received research support from Miami Heart Research Institute. The institution of Dr. Meschia has received research support from NINDS. The institution of Dr. Meschia has received research support from NINDS. Dr. Lin has nothing to disclose.