预测长期心血管结果中的视网膜血管口径:社区中的动脉样硬化风险研究
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
概括
视网膜血管口径,特别是较窄的动脉小管和较宽的静脉小管,预测了长期的心血管风险. 这种廉价的生物标志物改善了风险评估,尤其对女性来说,通过识别需要更密切监测动脉样硬化心血管疾病的人.
科学领域:
- 眼科 眼科
- 心脏病学
- 公共卫生
背景情况:
- 视网膜微血管结构的变化,包括较窄的动脉和较宽的静脉,与不良的心血管结果有关.
- 现有的动脉样硬化心血管疾病 (ASCVD) 风险预测模型可能无法完全捕捉所有风险因素.
研究的目的:
- 研究视网膜血管口径与长期心血管结果之间的关联.
- 确定视网膜血管口径是否提供超过2013年美国心脏病学会/美国心脏协会聚合队列方程 (PCE) 的增量预测值.
主要方法:
- 在没有先前ASCVD事件或心力衰竭的社区动脉样硬化风险研究 (ARIC) 中,对10,470名参与者进行了视网膜摄影.
- 参与者平均被跟踪了16年,以确定发生的冠心病,缺血性中风,心力衰竭和死亡率.
主要成果:
- 更宽的视网膜静脉和更窄的视网膜动脉与死亡,缺血性中风和冠心病 (女性) 的风险增加有关.
- 视网膜血管口径将21%最初被PCE归类为低风险的女性重新归类为中等风险的女性.
- 经过对静脉压进行调整后,与心力衰竭的相关性并不显著.
结论:
- 更窄的视网膜动脉和更宽的视网膜静脉是死亡率,缺血性中风和冠心病 (女性) 的独立长期预测因素.
- 视网膜血管口径是一种廉价,可复制的生物标志物,可提高ASCVD风险预测能力,特别是在低风险女性中.
- 这些发现支持将视网膜血管口径评估纳入常规心血管风险评估.
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