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Retinal Microvasculature: A Potential Window Into Heart Failure Prevention
Thanat Chaikijurajai1, Justis P Ehlers2, W H Wilson Tang3
1Kaufman Center for Heart Failure Treatment and Recovery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA; Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Retinal imaging offers a noninvasive method to detect early signs of heart failure (HF) by assessing microvascular changes. This technology aids in preventing HF and stratifying risk in at-risk populations.
Area of Science:
- Ophthalmology
- Cardiology
- Medical Imaging
Background:
- Endothelial dysfunction and microvascular disease are key factors in heart failure (HF) development and progression.
- Retinal imaging allows noninvasive assessment of vascular structure, function, and microcirculation.
- Existing evidence links retinal microvascular features to left ventricular changes and symptomatic HF development.
Purpose of the Study:
- To review current evidence on retinal microvasculature changes in relation to heart failure.
- To explore the clinical relevance and utility of retinal imaging in HF.
- To highlight the potential of retinal imaging as a noninvasive tool for HF prevention and risk stratification.
Main Methods:
- Review of accumulating evidence from various imaging modalities.
- Analysis of studies correlating retinal vascular characteristics with cardiac structure and function.
- Examination of dynamic retinal vessel analysis for HF phenotyping.
Main Results:
- Retinal vessel caliber and microvascular features are associated with stage B HF and incident symptomatic HF.
- Dynamic retinal vessel analysis can differentiate HF patient phenotypes.
- Advancements in imaging devices and AI enhance the potential of retinal imaging.
Conclusions:
- Retinal imaging is a promising noninvasive tool for HF assessment.
- It can complement cardiac imaging and biomarkers for HF prevention and risk stratification.
- Further research into retinal microvasculature changes can advance HF management.
