A full-width half-maximum method to assess retinal vascular structural changes in patients with ischemic heart disease and microvascular angina

Abstract

Chest pain patients without obstructive ischemic heart disease (IHD) have increased attention in the clinical practice as carrying higher cardiovascular (CV) risk and impaired life quality. Retinal vasculature is a novel but reliable risk factor of atherosclerosis and systemic vascular diseases. However, the association of retinal blood vessels and unobstructed IHD, as known as microvascular angina (MA) is poorly understood. This study compared retinal vascular structures of obstructive IHD and MA using spectral domain optical coherence tomography (SD-OCT) and full-width half-maximum (FWHM) methods to provide new risk predictive evidence of MA. Fundus vessels of 120 IHD patients, including 91epicardial IHD and 29 MA patients, and 66 control subjects were evaluated. Significant differences in the retinal arterial lumen diameter (RALD), retinal arterial outer diameter (RAOD), and arteriovenous ratio (AVR) have been found (P < 0.05). The severity of IHD was negatively correlated with diameters of RAOD, RALD and AVR (P < 0.05). In conclusion, there were significant differences in the retinal vascular structure between IHD patients and patients with MA. Thus, assessment of retinal vascular structure is suggested to evaluate CV risk of IHD patients, despite having no obstructive IHD.

Correlation of RETINAL Artery Diameter with Coronary Artery Disease: The RETINA CAD Pilot Study—Are the Eyes the Windows to the Heart?

“…There was also a statistically significant negative correlation between retinal artery diameter and SYNTAX score in women but not men. This trend was not noted in other OCT-A studies; however, more extensive population studies assessing alternative retinal microvasculature metrics utilizing other assessment modalities alluded to a similar signal [4,5,28,30,31]. The Atherosclerosis Risk in Communities Study (ARIC) study demonstrated that narrower retinal arterioles had a higher risk of CAD and cerebrovascular disease in females but not males [31,32].…”

“…More recent studies have evaluated this relationship using OCT-A, and the majority revealed an association between vascular density and CAD. Xu et al established that retinal artery lumen diameter, retinal artery outer diameter, and arteriovenous ratio had a statically significant negative correlation with the severity of CAD [28]. The EYE-Myocardial Infarction (EYE-MI) study concluded that retinal vasculature density was associated with higher cardiovascular risk factor burden, and was associated with a higher SYNTAX score.…”

A nomogramic model for predicting the left ventricular ejection fraction of STEMI patients after thrombolysis-transfer PCI

“…Hypertension is another important factor in AMI complicated by left ventricular dysfunction or congestive heart failure ( 24 , 25 ). The related mechanisms include: (1) Elevated shear stress in blood leads to impaired vascular endothelial function, thereby compromising the ability of endothelium-mediated hyperpolarization to regulate contraction of smooth muscle cells ( 26 ); (2) increased nitric oxide production and inflammatory factors released from vascular endothelial cells in hypertensive patients lead to coronary microcirculatory dysfunction ( 27 ); and (3) oxidative stress caused by excessive bioavailability of reactive oxygen species (ROS) in hypertensive patients aggravates vascular damage ( 28 ). Thus, hypertension may result in more severe myocardial ischemia and increased cardiac load, thereby affecting cardiac function in STEMI patients.However, our results did not show that hypertension caused a reduction in LVEF for the pupulation with TTPCI.…”

Quantitative analysis of blooming artifact caused by calcification based on X-ray energy difference using computed tomography

“…Adjacent pixels affected by calcification were defined using the following formula: representing the brightened length excluding the actual calcified length. For both phantom and clinical studies, the actual calcified length was determined using the definition of the FW3M instead of the FWHM, which is a widely used measurement method 26 . A third and half maximum attenuation value of the calcified length with a background value of zero was used for the FW3M and FWHM measurements, respectively.…”