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Correlation between diastolic function and fundus vascular features in coronary heart disease
Jin Wang1, Yu-Cen Wang2, Luoziyi Wang2
1Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Insights
In coronary heart disease (CHD) patients, impaired cardiac diastolic function is linked to changes in retinal and choroidal vascular features. These fundus vascular changes may predict circulatory disturbances caused by diastolic dysfunction.
Area of Science:
- Ophthalmology
- Cardiology
- Medical Imaging
Background:
- Coronary heart disease (CHD) is a significant global health concern.
- Cardiac diastolic function plays a crucial role in overall cardiovascular health.
- Understanding the link between cardiac function and ocular vasculature is important for comprehensive patient assessment.
Purpose of the Study:
- To investigate the correlation between cardiac diastolic function parameters and retinal/choroidal vascular features in patients with CHD.
- To determine if ocular vascular metrics can serve as indicators of diastolic dysfunction in CHD.
Main Methods:
- An observational clinical cohort study involving 206 CHD patients.
- Utilized Optical Coherence Tomography (OCT) and OCT Angiography (OCTA) for retinal and choroidal imaging.
- Echocardiography was performed to assess cardiac diastolic function.
Main Results:
- Positive correlations were observed between parameters like Left Ventricular End-Diastolic diameter (LVED) and retinal thickness.
- Negative correlations were found between the Early (E) to Early (E') diastolic mitral inflow velocity to mitral annular velocity (E/E') ratio and pulmonary arterial systolic pressure (PASP) with retinal thickness.
- Vessel density in retinal and choroidal layers showed significant correlations with diastolic function indices, including the E/A ratio and E/E' ratio.
Conclusions:
- Macular retinal and choroidal thickness, vascular density, and perfusion are potentially sensitive predictors of fundus circulatory disturbances in CHD patients.
- These findings highlight the potential of ocular imaging as a non-invasive tool to assess the impact of impaired cardiac diastolic function.
- Further research may elucidate the clinical utility of these biomarkers in managing CHD.
Aim:
To assess the correlation between cardiac diastolic function and retinal/choroidal vascular features in patients with coronary heart disease (CHD).
Methods:
This observational clinical cohort study included 206 CHD patients (412 eyes). Optical coherence tomography (OCT) and OCT angiography (OCTA) images were obtained from each participant using the AngioVue Imaging System. Each patient also underwent echocardiography to evaluate cardiac diastolic function.
Results:
Several correlations were found between cardiac diastolic function and fundus vascular features in CHD patients. Left ventricular end-diastolic diameter (LVED), interventricular septal thickness in diastole (IVSD), left ventricular posterior wall thickness in diastole (LVPWD), and early (E) to atrial (A) wave velocity (E/A ratio) positively correlated with retinal thickness, while early (E) diastolic mitral inflow velocity to early (E') diastolic mitral annular velocity (E/E' ratio) and pulmonary arterial systolic pressure (PASP) negatively correlated. Significant associations were noted for LVED and PASP across several retinal regions, excluding the foveal central subfield. Vessel density in superficial capillary plexus (SCP) and deep capillary plexus (DCP) layers had negative correlations with IVSD, LVPWD, and E/E' ratio, but a positive correlation with E/A ratio. The choriocapillaris (CC) layer's vessel density positively correlated with the E/A ratio and negatively with the E/E' ratio. LVPWD and E/A ratio positively correlated with choroidal perfusion, while E/E' ratio showed a negative correlation. LVED, pulmonary artery diameter (PA), and PASP showed no significant associations with retinal or choroidal perfusion.
Conclusion:
In CHD patients, macular retinal/choroidal thickness, vascular density across different layers, and perfusion may serve as useful and sensitive predictors of fundus circulatory disturbances resulting from impaired cardiac diastolic function.
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