LUMEN NARROWING OF RETINAL ARTERIOLES IS A VALUABLE BIOMARKER OF CARDIAC DAMAGE

Abstract

Objective: The aim of the study was to establish the relationship between structural and functional abnormalities of retinal microcirculation and cardiac damage defined as the presence of left ventricle hypertrophy and/or diastolic dysfunction. Design and method: The study consisted of 88 patients with essential hypertension (54.3 ± 8.3 years, 44.3% were female) and 32 healthy subjects. Inclusion criteria were: essential hypertension, age of 40–70 years old. Exclusion criteria were: secondary hypertension, any cardiovascular disease including heart failure, coronary artery disease, arrhythmia, moderate or severe valve disease, history of stroke or transient ischemic attack, chronic kidney disease with eGFR < 60 mml/min/1.73 m2, diabetes mellitus, eye disease, pregnancy. Scanning laser Doppler flowmetry was used to evaluate retinal structure and function. Diastolic dysfunction and left ventricle hypertrophy were analysed by echocardiography. The group was divided into two subgroups: 1. hypertensives without cardiac damage (n = 55); 2. hypertensives with cardiac damage (n = 33). Cardiac damage was defined as the presence of left ventricle hypertrophy and/or diastolic dysfunction. Results: Among all retinal parameters lumen diameter was significantly smaller in patients with cardiac damage versus healthy subjects (77 vs. 83 μm, p < 0.05). Lumen diameter revealed a significant decreasing trend across the groups of controls, patients without cardiac damage and patients with concomitant cardiac damage (84 vs. 81 vs. 77 μm, p trend <0.01). Moreover, in correlation analysis lumen diameter was inversely related to intraventricular septum diameter (r = −0.25 p < 0.05), left ventricular mass (r = −0.23, p < 0.05) and left atrial volume (r = −0.22 p < 0.05). These associations remained significant even after adjustment for age, sex and mean blood pressure in multivariate analysis: intraventricular septum diameter (β = −1.1 p < 0.05), left ventricular mass (β = −0.4, p < 0.05) and left atrial volume (β = −0.05 p < 0.05). The association of lumen diameter with diastolic dysfunction indices apart left atrial volume was not observed. Conclusions: Retinal examination performed by mean of scanning laser Doppler flowmetry is of great value in detecting patients with cardiac damage. Lumen narrowing of retinal arterioles was independently associated with intraventricular septum diameter, left ventricular mass and left atrial volume.