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Assessment of Indices of Conjunctival Microvascular Function in Patients With and Without Obstructive Coronary Artery

Jonathan A Mailey1, Julie S Moore2, Paul F Brennan3

  • 1Department of Cardiology, Royal Victoria Hospital, Belfast Health and Social Care Trust, Belfast, United Kingdom; Biomedical Sciences Research Institute, Ulster University, Coleraine, United Kingdom.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|January 27, 2023
PubMed

Insights

Conjunctival microcirculation is altered in patients with coronary artery disease. This non-invasive assessment of the conjunctiva may aid in cardiovascular risk screening.

Area of Science:

  • Cardiovascular Medicine
  • Ophthalmology
  • Medical Imaging

Background:

  • Atherosclerotic heart disease is often asymptomatic until a major adverse cardiovascular event.
  • Conventional screening methods can misattribute cardiovascular risk.
  • Non-invasive vascular imaging, like conjunctival evaluation, offers an alternative to radiation-based methods.

Purpose of the Study:

  • To compare conjunctival microcirculatory function in patients with obstructive coronary artery disease versus those without.
  • To investigate the potential of conjunctival imaging for cardiovascular risk assessment.

Main Methods:

  • A smartphone and slit-lamp biomicroscope combination was used for conjunctival imaging.
  • Microvascular indices including axial velocity (Va), cross-sectional velocity (Vcs), blood flow rate (Q), and wall shear rate (WSR) were measured.
  • Comparison was made between patients with myocardial infarction (MI-cohort) and controls with no obstructive coronary artery disease (NO-CAD cohort).

Main Results:

  • A total of 127 patients (66 MI, 61 NO-CAD) and 3602 conjunctival vessels were analyzed.
  • Significantly lower mean Va, Vcs, and Q were observed in the MI cohort compared to the NO-CAD cohort.
  • Wall shear rate (WSR) was also lower in the MI cohort, even after correcting for vessel diameter differences.

Conclusions:

  • Alterations in conjunctival microcirculation are detectable in patients with obstructive coronary artery disease.
  • The conjunctival microvasculature shows promise as a non-invasive tool for cardiovascular risk screening.
Abstract

Keywords:
Cardiovascular diseaseCardiovascular screeningConjunctivaCoronary artery diseaseMicrovascular dysfunctionPrevention

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