Retinal Microvascular Abnormalities Predict Clinical Outcomes in Patients with Heart Failure

Background: Narrower retinal arterioles and wider retinal venules have been associated with the incidence of heart failure (HF). However, whether they are predictive of the prognosis of heart failure (HF) is unclear. We aimed to explore the role of retinal vessel calibers in predicting long-term cli...

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Main Authors: Shaohua Guo, Songtao Yin, Wenhua Song, Gary Tse, Juping Liu, Kaiwen Hei, Kangyin Chen, Long Su, Tong Liu
Format: Article
Language:English
Published: MDPI AG 2022-08-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/12/9/2078
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author Shaohua Guo
Songtao Yin
Wenhua Song
Gary Tse
Juping Liu
Kaiwen Hei
Kangyin Chen
Long Su
Tong Liu
author_facet Shaohua Guo
Songtao Yin
Wenhua Song
Gary Tse
Juping Liu
Kaiwen Hei
Kangyin Chen
Long Su
Tong Liu
author_sort Shaohua Guo
collection DOAJ
description Background: Narrower retinal arterioles and wider retinal venules have been associated with the incidence of heart failure (HF). However, whether they are predictive of the prognosis of heart failure (HF) is unclear. We aimed to explore the role of retinal vessel calibers in predicting long-term clinical outcomes of HF. Methods: This is a prospective, single-center, observational study that surveyed patients in a tertiary referral hospital for the treatment of HF. Retinal vessel caliber was graded using retinal photography. The primary endpoint was the composite endpoint of HF rehospitalization and mortality at 12 months. Results: There were 55 patients with chronic HF included in the final analysis. At 12 months, the cumulative incidence of the primary endpoint, HF rehospitalization, and mortality tended to be higher with the widening of the central retinal venular equivalent (CRVE) (<i>p</i> for non-linearity = 0.059) and was significantly increased when CRVE reached a cut-off value (283 μm) (<i>p</i> = 0.011) following adjustment for age, sex, etiology of HF, and diabetes. No association between the central retinal arteriolar equivalent (CRAE) and arteriolar-to-venular caliber ratio (AVR) was found with the clinical outcome in both univariable and multivariable Cox regression. CRAE, CRVE, and AVR had no relationship with the concentration of the N-terminal pro-B-type natriuretic peptide. In addition, CRVE was not associated with cardiac diastolic and systolic function. Conclusions: When the retinal venular caliber widens to a certain point, the composite incidence of HF rehospitalization and mortality significantly increase, suggesting retinal vessel caliber imaging may provide insight into the development of HF.
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spelling doaj.art-ff0b22c12d6e428b8a347b41e308e4702023-11-23T15:48:23ZengMDPI AGDiagnostics2075-44182022-08-01129207810.3390/diagnostics12092078Retinal Microvascular Abnormalities Predict Clinical Outcomes in Patients with Heart FailureShaohua Guo0Songtao Yin1Wenhua Song2Gary Tse3Juping Liu4Kaiwen Hei5Kangyin Chen6Long Su7Tong Liu8Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, ChinaDepartment of Ophthalmology, Second Hospital of Tianjin Medical University, Tianjin 300211, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, ChinaTianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, ChinaTianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, ChinaDepartment of Ophthalmology, Second Hospital of Tianjin Medical University, Tianjin 300211, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, ChinaBackground: Narrower retinal arterioles and wider retinal venules have been associated with the incidence of heart failure (HF). However, whether they are predictive of the prognosis of heart failure (HF) is unclear. We aimed to explore the role of retinal vessel calibers in predicting long-term clinical outcomes of HF. Methods: This is a prospective, single-center, observational study that surveyed patients in a tertiary referral hospital for the treatment of HF. Retinal vessel caliber was graded using retinal photography. The primary endpoint was the composite endpoint of HF rehospitalization and mortality at 12 months. Results: There were 55 patients with chronic HF included in the final analysis. At 12 months, the cumulative incidence of the primary endpoint, HF rehospitalization, and mortality tended to be higher with the widening of the central retinal venular equivalent (CRVE) (<i>p</i> for non-linearity = 0.059) and was significantly increased when CRVE reached a cut-off value (283 μm) (<i>p</i> = 0.011) following adjustment for age, sex, etiology of HF, and diabetes. No association between the central retinal arteriolar equivalent (CRAE) and arteriolar-to-venular caliber ratio (AVR) was found with the clinical outcome in both univariable and multivariable Cox regression. CRAE, CRVE, and AVR had no relationship with the concentration of the N-terminal pro-B-type natriuretic peptide. In addition, CRVE was not associated with cardiac diastolic and systolic function. Conclusions: When the retinal venular caliber widens to a certain point, the composite incidence of HF rehospitalization and mortality significantly increase, suggesting retinal vessel caliber imaging may provide insight into the development of HF.https://www.mdpi.com/2075-4418/12/9/2078heart failureretinal vessel analysismicrocirculationprognosis
spellingShingle Shaohua Guo
Songtao Yin
Wenhua Song
Gary Tse
Juping Liu
Kaiwen Hei
Kangyin Chen
Long Su
Tong Liu
Retinal Microvascular Abnormalities Predict Clinical Outcomes in Patients with Heart Failure
Diagnostics
heart failure
retinal vessel analysis
microcirculation
prognosis
title Retinal Microvascular Abnormalities Predict Clinical Outcomes in Patients with Heart Failure
title_full Retinal Microvascular Abnormalities Predict Clinical Outcomes in Patients with Heart Failure
title_fullStr Retinal Microvascular Abnormalities Predict Clinical Outcomes in Patients with Heart Failure
title_full_unstemmed Retinal Microvascular Abnormalities Predict Clinical Outcomes in Patients with Heart Failure
title_short Retinal Microvascular Abnormalities Predict Clinical Outcomes in Patients with Heart Failure
title_sort retinal microvascular abnormalities predict clinical outcomes in patients with heart failure
topic heart failure
retinal vessel analysis
microcirculation
prognosis
url https://www.mdpi.com/2075-4418/12/9/2078
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