Cardiac Structure Relates to Hemorrhagic Cerebral Small Vessel Disease Phenotype

Background Most intracerebral hemorrhages (ICH) are caused by 1 of 2 cerebral small vessel diseases (cSVDs): arteriolosclerosis and cerebral amyloid angiopathy (CAA). Hypertension is a major risk factor for ICH, but its contribution to the hemorrhagic manifestations of these arteriopathies remains uncertain. We investigated associations between a cardiac structural biomarker of systemic hypertension (left ventricular mass [LVM]) and cSVD neuroimaging phenotype in patients with ICH. Methods We assessed brain magnetic resonance imaging and echocardiography cross‐sectional data from patients with symptomatic hemorrhagic cSVD, including macroscopic ICH, convexity subarachnoid hemorrhage, or cognitive impairment. We compared LVM in patients with possible or probable CAA, mixed pattern cSVD, or arteriolosclerosis. We used linear regression models to investigate associations between LVM, patient characteristics, and SVD. Results We included 216 patients (104 with CAA, 91 with mixed pattern cSVD, and 21 with arteriolosclerosis). Patients with CAA had a significantly lower mean LVM (148.8±44.9 g) compared with those with mixed pattern cSVD or arteriolosclerosis (172.8±59.3 g) ( P