Abstract:

Background: Left ventricular hypertrophy is a pathophysiological response to chronic hypertension and is an independent risk factor for vascular events. We sought to determine the magnitude, correlates and prognosis of left ventricular hypertrophy in young patients presenting with their rst stroke at a tertiary hospital. We also sought to determine the accuracy of electrocardiography using Sokolow-Lyon and Cornell criteria in detecting left ventricular hypertrophy compared to echocardiography.

Methods: This cohort study prospectively recruited consecutive stroke patients aged 18-45 years who had undergone brain imaging, electrocardiogram and transthoracic echocardiography. Baseline data were recorded and correlates of left ventricular hypertrophy were identi ed using the modi ed Poisson regression. Follow-up for functional outcomes was performed to 30-days using the modi ed Rankin Scale.

Results: We enrolled 101 participants with rst ever stroke. The mean age of patients was 39.7 years and the mean National Institutes of Health Stroke Score was 18, re ecting severe disability. Brain imaging revealed ischemic strokes in 60 (59.4%) of patients and of those with intracerebral hemorrhage, 33 (86.8%) were localized to the basal ganglia, in keeping with a hypertensive etiology. Left ventricular hypertrophy was present in 76 (75.3%; 95% CI 65.7%–83.3%), and 30 (39.5%) and 28 (36.8%) had moderate to severe degree respectively. Young adults with left ventricular hypertrophy were more likely to have a higher systolic and diastolic blood pressure on arrival 156.3±19 and 96.4±10.6 respectively. On multivariable analysis, lack of …