Retinal vascular changes and right ventricular structure and function: the MESA-Right Ventricle and MESA-Eye studies

Retinal vessel diameters have been associated with left ventricular morphology and function but their relationship with the right ventricle (RV) has not been studied. We hypothesized that wider retinal venules and narrower retinal arterioles are associated with RV morphology and function. RV end-diastolic mass (RVEDM), end-diastolic volume (RVEDV), end-systolic volume (RVESV), stroke volume (RVSV), and ejection fraction (RVEF) were assessed using cardiac magnetic resonance imaging (MRI) scans of 4204 participants without clinical cardiovascular disease at the baseline examination; retinal photography was obtained at the second examination. Mean diameters of retinal arterioles and venules were measured and summarized as central retinal vein and artery equivalents ("veins" and "arteries," respectively). After adjusting for covariates, wider veins were associated with greater RVEDM and RVEDV in women (P = 0.04 and P = 0.02, respectively), whereas there was an inverse association with RVEDV in men (P = 0.02). In both sexes, narrower arteries were associated with lower RVEDM (P < 0.001 in women and P = 0.002 in men) and smaller RVEDV (P < 0.001 in women and P = 0.04 in men) in adjusted models. Narrower arteries were also associated with lower RVEF in men but this was of borderline significance after adjusting for the LVEF (P = 0.08). Wider retinal venular diameter was associated with sex-specific changes in RVEDM and RVEDV in adults without clinical cardiovascular disease. Narrower retinal arteriolar diameter was associated with significantly lower RVEDM and smaller RVEDV in both sexes.