A spectrum of retinal vasculature measures and coronary artery disease.

Autor: Wang SB; Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, NSW, Australia., Mitchell P; Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, NSW, Australia., Liew G; Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, NSW, Australia., Wong TY; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore., Phan K; Centre for Heart Research, Westmead Institute for Medical Research, University of Sydney, NSW, Australia., Thiagalingam A; Centre for Heart Research, Westmead Institute for Medical Research, University of Sydney, NSW, Australia., Joachim N; Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, NSW, Australia., Burlutsky G; Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, NSW, Australia., Gopinath B; Centre for Vision Research, Westmead Institute for Medical Research, University of Sydney, NSW, Australia. Electronic address: bamini.gopinath@sydney.edu.au.
Jazyk: angličtina
Zdroj: Atherosclerosis [Atherosclerosis] 2018 Jan; Vol. 268, pp. 215-224. Date of Electronic Publication: 2017 Oct 10.
DOI: 10.1016/j.atherosclerosis.2017.10.008
Abstrakt: Background and Aims: We aimed to comprehensively describe a spectrum of retinal vessel measures including fractal dimension (D f ) and their associations with indices of coronary artery disease (CAD) extent and severity, as well as hypertension and diabetes.
Methods: The Australian Heart Eye Study (AHES) is an observational study that surveyed 1680 participants presenting to a tertiary referral hospital for the evaluation of potential CAD by coronary angiography. A range of newer retinal vessel geometric measures (D f , curvature tortuosity, and branching angle) were quantified from retinal photographs using semi-automated software, the Singapore 'I' Vessel Assessment (SIVA) tool. A combined retinal score was constructed, aiming to assess the joint effect of multiple retinal vessel parameters on CAD, comprising of those variables that were most strongly significant in multivariate analysis - D f , arteriolar curvature tortuosity, and retinal arteriolar calibre. CAD was objectively quantified using a range of measures obtained from coronary angiography.
Results: A total of 1187 participants had complete data on retinal vessel measurements and coronary vessel evaluation. Retinal vascular D f and curvature tortuosity decreased with increasing age; women had significantly lower D f than men (p<0.003). Straighter retinal vessels were associated with CAD extent and Gensini scores in multivariable analysis (p<0.02). Accounting for media opacity by sub-group analysis in pseudophakic patients, the combined retinal score was associated with stenosis greater than 50% in any coronary artery segment (vessel score) and obstructive coronary stenosis in all three main coronary arteries (segment score) (p = 0.01). Lower D f and narrower arteriolar branching angle were associated with CAD vessel score (p<0.03). In sex-stratified multivariate analyses, straighter arterioles were associated with greater odds of CAD in men, and narrower venular branching angle was associated with CAD in women.
Conclusions: A range of retinal vessel measures were associated with CAD extent and severity. A sparser retinal microvascular network (smaller D f ) was associated with older age and female gender. After accounting for the impact of media opacity, retinal vessel measures were associated with more diffuse and severe CAD.
(Copyright © 2017 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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