Joanna M Harazny1, Christian Ott, Ulrike Raff, Jürgen Welzenbach, Norbert Kwella, Georg Michelson, Roland E Schmieder. 1. aDepartment of Nephrology and Hypertension, University of Erlangen-Nuremberg, Erlangen-Nuremberg, Germany bDepartment of Pathophysiology cDepartment of Nephrology and Hypertension, University of Warmia and Masury, Olsztyn, Poland dDepartment of Ophthalmology, University of Erlangen-Nuremberg, Erlangen-Nuremberg, Germany.
Abstract
OBJECTIVE: Increased pulsatile pressure induces as well as aggravates microvascular damage. Scanning laser Doppler flowmetry allows the noninvasive assessment of both retinal capillary flow (RCF) and arteriolar structural parameters of the retinal circulation. Moreover, pulsatile characteristics of the retinal arterioles can be assessed. METHODS: In study 1, reliability of pulsatile RCF and structural parameters were examined in randomly selected patients. In study 2, pulsatile RCF as well as the structural parameters of retinal arterioles were assessed in hypertension grade 1-2 (HT1-2; n = 20) and treatment-resistant hypertension (TRH; n = 19). RESULTS: In study 1, test-retest, interobserver and intraobserver reliability of all parameters showed coefficients of variation of less than 10%. In study 2, it was shown that patients with TRH had higher pulse pressure (P = 0.003) and pulsed RCF values (P < 0.001) as patients with HT1-2. Patients with HT1-2 had no change in the vessel diameter, but a significant difference in lumen diameter, resulting in an altered wall thickness (P = 0.001) between systole and diastole. In contrast, patients with TRH showed differences in vessel diameter (P = 0.005) as well as lumen diameter (P = 0.001), resulting in an unaltered wall thickness between systole and diastole. Hence, wall thickness change as a result of pulsed flow regulation observed in HT1-2 was missing in TRH. CONCLUSION: We suggest a new reliable tool for evaluating the pulsatility in the retinal circulation in humans, and found significant differences in pulsatile RCF and structural parameters between patients with HT1-2 and those with TRH.
OBJECTIVE: Increased pulsatile pressure induces as well as aggravates microvascular damage. Scanning laser Doppler flowmetry allows the noninvasive assessment of both retinal capillary flow (RCF) and arteriolar structural parameters of the retinal circulation. Moreover, pulsatile characteristics of the retinal arterioles can be assessed. METHODS: In study 1, reliability of pulsatile RCF and structural parameters were examined in randomly selected patients. In study 2, pulsatile RCF as well as the structural parameters of retinal arterioles were assessed in hypertension grade 1-2 (HT1-2; n = 20) and treatment-resistant hypertension (TRH; n = 19). RESULTS: In study 1, test-retest, interobserver and intraobserver reliability of all parameters showed coefficients of variation of less than 10%. In study 2, it was shown that patients with TRH had higher pulse pressure (P = 0.003) and pulsed RCF values (P < 0.001) as patients with HT1-2. Patients with HT1-2 had no change in the vessel diameter, but a significant difference in lumen diameter, resulting in an altered wall thickness (P = 0.001) between systole and diastole. In contrast, patients with TRH showed differences in vessel diameter (P = 0.005) as well as lumen diameter (P = 0.001), resulting in an unaltered wall thickness between systole and diastole. Hence, wall thickness change as a result of pulsed flow regulation observed in HT1-2 was missing in TRH. CONCLUSION: We suggest a new reliable tool for evaluating the pulsatility in the retinal circulation in humans, and found significant differences in pulsatile RCF and structural parameters between patients with HT1-2 and those with TRH.
Authors: Christian Ott; Joanna M Harazny; Axel Schmid; Tilmann Ditting; Roland Veelken; Marek Bladowski; Georg Michelson; Michael Uder; Roland E Schmieder Journal: Clin Res Cardiol Date: 2015-04-28 Impact factor: 5.460
Authors: Susanne Jung; Julie Kolwelter; Agnes Bosch; Renata Cífková; Joanna M Harazny; Christian Ott; Stephan Achenbach; Roland E Schmieder Journal: ESC Heart Fail Date: 2021-03-30