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Correlation of echocardiographic findings with cerebral infarction in elderly adults: the AGES-Reykjavik study.

ABSTRACT: Chronic effects of hypertension may be observed in multiple end organs. Previous reports suggest that cardiovascular morphological features can mirror cerebral infarction. In this cross-sectional analysis of elderly subjects, we investigated the relationship of a comprehensive set of echocardiographic measures with cerebral infarction detected by MRI.We compared echocardiographically determined left ventricular (LV) mass, left atrial volume, aortic root diameter, mitral annular calcification, and measures of diastolic function with cerebral infarction determined by MRI using logistic regression in a random sample drawn from the Age Gene/Environment Susceptibility-Reykjavik Study cohort. The model was first adjusted for age and gender, and then for age, gender, and vascular risk factors.Among 692 subjects aged 75 (standard deviation, 6) years, 28% had at least 1 cerebral infarct. When adjusted for age and gender, the presence of cerebral infarction was modestly related to LV mass (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.00-1.02) and left atrial volume (OR, 1.03; 95% CI, 1.01-1.05), as well as the lowest quartile of early-to-late pulsed Doppler velocity ratio (early-to-late pulsed Doppler velocity ratio <0.75; OR, 1.87; 95% CI, 1.22-2.87). The latter relation remained significant after adjustment for vascular risk factors and LV ejection fraction (OR, 1.82; 95% CI, 1.16-2.86).Of all echocardiographic parameters, LV filling abnormality as indicated by low early-to-late pulsed Doppler velocity ratio displayed the strongest association with cerebral infarction and this relationship was independent of vascular risk factors. This simple marker of cerebral infarction may be useful when evaluating older patients.

SUBMITTER: McAreavey D

PROVIDER: S-EPMC3008777 | biostudies-literature | 2010 Oct

REPOSITORIES: biostudies-literature

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Correlation of echocardiographic findings with cerebral infarction in elderly adults: the AGES-Reykjavik study.

McAreavey Dorothea D Vidal Jean-Sébastien JS Aspelund Thor T Owens David S DS Hughes Timothy T Garcia Melissa M Sigurdsson Sigurdur S Bjornsdottir Halldora H Harris Tamara B TB Gudnason Vilmundur V Launer Lenore J LJ Plehn Jonathan F JF

Stroke 20100826 10

<h4>Background and purpose</h4>Chronic effects of hypertension may be observed in multiple end organs. Previous reports suggest that cardiovascular morphological features can mirror cerebral infarction. In this cross-sectional analysis of elderly subjects, we investigated the relationship of a comprehensive set of echocardiographic measures with cerebral infarction detected by MRI.<h4>Methods</h4>We compared echocardiographically determined left ventricular (LV) mass, left atrial volume, aortic ...[more]

PMID: 20798368

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Project description:BackgroundThe debate whether "asymptomatic hyperuricemia" should be treated is still ongoing. The objective of this cross-sectional study was to analyze whether hyperuricema in the elderly is associated with joint pain.Methods and findingsParticipants in the population-based AGES-Reykjavik Study (males 2195, females 2975, mean age 76(6)) answered standardized questions about joint pain. In addition they recorded intermittent hand joint pain by marking a diagram of the hand. In males, no association was found between hyperuricemia and pain. Females however, showed a positive association between hyperuricemia and joint pain at many sites. After adjustment for age, BMI and hand osteoarthritis however, only intermittent hand joint pain (OR 1.30(1.07-1.58), p = 0.008) and intermittent pain in ?10 hand joints (OR 1.75(1.32-2.31), p<0.001) remained significant. The best model for describing the relationship between serum uric acid levels (SUA) and intermittent hand joint pain in ?10 joints was non-linear with a cut-off at 372 ?mol/L. The attributable surplus number of symptomatic females with SUA ?372 ?mol/L was approximately 2.0% of the study population for those reporting pain in ?10 hand joints. Next after having severe hand osteoarthritis, SUA ?372 was an independent predictive factor of intermittent pain in ?10 hand joints. Intermittent hand joint pain was also an independent risk factor for worse general health description.ConclusionResults from this population based study indicate that hyperuricemia in elderly females may be a rather frequent cause of intermittent hand joint pain, often in many joints. The most likely explanation relates to low-grade urate crystal induced inflammation. Our data do not allow for assessment of the severity of symptoms or whether they merit specific treatment, but intermittent hand joint pain was an independent predictor of worse general health. These findings may be an important contribution to the debate on whether hyperuricemia should be treated.

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Correlation of echocardiographic findings with cerebral infarction in elderly adults: the AGES-Reykjavik study.

Publications

Correlation of echocardiographic findings with cerebral infarction in elderly adults: the AGES-Reykjavik study.

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