長期の心血管疾患の予測における網膜血管カリバー:コミュニティにおける動脈硬化リスクに関する研究
Sara B Seidelmann1, Brian Claggett1, Paco E Bravo1
1From Cardiovascular Division (S.B.S, B.D., P.E.G., A.G., H.F., M.D.C., S.D.S.) and Department of Radiology, Division of Cardiovascular Imaging (S.B.S, P.E.G., A.G., H.F., M.D.C.), Brigham and Women's Hospital, Boston, MA; and Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health University of Wisconsin, Madison (B.E.K., R.K.).
Circulation
|September 30, 2016
まとめ
網膜の血管の大きさ 特に細かい動脈と広い静脈は 長期的な心血管リスクを予測します この安価なバイオマーカーは,特に女性の場合,動脈硬化性心血管疾患のより密接な監視を必要とする個人を特定することによって,リスク評価を改善します.
科学分野:
- 眼科について
- 心臓病科
- 公衆衛生
背景:
- 狭い動脈と広い静脈を含む網膜の微血管の変化は,有害な心血管的結果と関連しています.
- 動脈硬化性心血管疾患 (ASCVD) に対する既存のリスク予測モデルは,すべてのリスク要因を完全に捉えることはできません.
研究 の 目的:
- 網膜血管の口径と長期的な心血管疾患との関連を調べる
- 網膜血管のキャリバーが,2013年のアメリカ心臓学会/アメリカ心臓協会のプール・コホート方程式 (PCE) を超えたインクリメンタル予測値を提供するかどうかを判断する.
主な方法:
- 前例のASCVDまたは心不全のない10, 470人の参加者に網膜写真撮影が行われました.
- 参加者は平均16年間追跡され,発症冠動脈疾患,不全性脳卒中,心不全,および死亡率を確認した.
主要な成果:
- より広い網膜静脈とより狭い網膜動脈は,死亡率,不全性脳卒中,冠動脈疾患 (女性) のリスクの増加と関連していました.
- PCEによって初期に低リスクと分類された女性の21%を中等リスクのカテゴリーに再分類しました.
- 収縮血圧を調整したところ,心不全との関連は有意ではなかった.
結論:
- 狭い網膜動脈と広い網膜静脈は,死亡率,不全性脳卒中,冠動脈疾患 (女性) の独立した長期的な予測因子です.
- 網膜血管のキャリバーは安価で再現可能なバイオマーカーであり,特に低リスクの女性ではASCVDのリスク予測を高めます.
- これらの発見は,網膜血管のキャリバーの評価を日常的な心血管リスク評価に統合することを支持しています.
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