Literature DB >> 29069316

Retinal microvascular dysfunction in heart failure.

Matthias P Nägele1, Jens Barthelmes1, Valeria Ludovici1,2, Silviya Cantatore1, Arnold von Eckardstein1, Frank Enseleit1, Thomas F Lüscher1, Frank Ruschitzka1, Isabella Sudano1, Andreas J Flammer1.   

Abstract

Aims: Retinal vessel analysis (RVA) represents a novel, non-invasive, and reliable method to study the microcirculation in the eye. The goal of this study was to assess the extent of retinal microvascular dysfunction in patients with chronic heart failure (CHF) compared to controls and established measures of vascular function. Methods and results: In this prospective, single-centre, observational study, 74 patients with compensated CHF (mean age 63.5 ± 11.2 years, 32% female, mean left-ventricular ejection fraction 37 ± 12.8%), 74 patients with cardiovascular risk factors (CVRF; 64.1 ± 12.7 years, 34% female), and 74 healthy controls (HC; 57.8 ± 14.2 years, 35% female) were included. The primary endpoint, flicker-induced dilatation of retinal arterioles (FIDart), was significantly reduced in patients with CHF compared to CVRF and HC (mean FIDart 0.9 ±  0.2 vs. 2.3 ± 0.3 and vs. 3.6 ± 0.3%, respectively, both P < 0.001 before and after propensity score-weighted analysis). Similar differences were seen for venular FID. FIDart was less impaired in patients with dilated compared to ischaemic cardiomyopathy. No significant differences were observed for arteriovenous ratio and flow-mediated dilatation. Impaired FIDven was associated with echocardiographically estimated systolic pulmonary artery pressure and left atrial volume index.
Conclusion: Retinal microvascular dilatation in response to flicker light is impaired in CHF. RVA may represent a new and useful method to non-invasively monitor microvascular abnormalities in heart failure in an easy and standardized way without the use of radiation. Published on behalf of the European Society of Cardiology. All rights reserved.
© The Author 2017. For permissions, please email: journals.permissions@oup.com.

Entities:  

Keywords:  Endothelial dysfunction ; Heart failure ; Microcirculation ; Retinal vessel analysis

Mesh:

Year:  2018        PMID: 29069316     DOI: 10.1093/eurheartj/ehx565

Source DB:  PubMed          Journal:  Eur Heart J        ISSN: 0195-668X            Impact factor:   29.983


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