Pulse Waveform Analysis in Ocular Microcirculation by Laser Speckle Flowgraphy in Patients with Left Ventricular Systolic and Diastolic Dysfunction

Abstract

Purpose: To determine: (1) whether variables of a pulse wave form analysis of ocular microcirculation shown by laser speckle flowgraphy (LSFG) correlate with left ventricular (LV) systolic dysfunction and (2) whether these variables correlate with LV diastolic dysfunction in subjects without LV systolic dysfunction as assessed by echocardiography. Methods: We studied 200 consecutive subjects. LV systolic dysfunction has been determined to be present when the LV ejection fraction was < 50%. LV diastolic dysfunction was diagnosed when subjects had an E/e’ ratio ≥15 and an e’ velocity < 10 cm/s. We evaluated the pulse waveform analysis variables “rising rate” and the blowout score (BOS) using LSFG in the optic nerve head (ONH) and choroid. Results: The brain natriuretic peptide (BNP) level, the rising rate in the choroid area (rising rate-choroid), and heart rate were revealed as independent factors for LV systolic dysfunction, and BOS-choroid was identified as an independent factor for LV diastolic dysfunction. The areas under the curve (AUC) of BNP and rising rate-choroid for LV systolic dysfunction were 0.83 and 0.81, respectively. The AUC of BOS-choroid for LV diastolic dysfunction was 0.73. Conclusion: Pulse waveform analysis in the choroid has a significant correlation with LV systolic and LV diastolic function.

Influence of age and gender on the pulse waveform in optic nerve head circulation in healthy men and women

“…Other researchers reported that BOT-Tissue may be used to detect silent brain infarction in primary aldosteronism 22 . Lower BOS values in the ONH were also found to be correlated with increasing carotid artery plaque formation 14 and decreasing left ventricular diastolic function 16 . In addition, we demonstrated that the ATI in the ONH is significantly negatively correlated with the left ventricular mass 15 , and that the rising rate is significantly positively correlated with the left ventricular ejection fraction 16 .…”

“…Variation in the MBR have various pulse waveform patterns that are synchronized with the cardiac cycle. We noticed on the relationship between the pulse waveform and various large vessel status, and we found that the pulse waveform obtained by LSFG was significantly correlated with age, the ba-PWV 11,12 , the cardio ankle vascular index (CAVI) 12,13 , the carotid intima media thickness and carotid artery plaque formation 14 , left ventricular endo-diastolic pressure, left ventricular mass 15 , left ventricular ejection fraction 15,16 , and the systemic vascular resistance calculated with the use of a Swan-Ganz catheter 17 . Our confirmation suggested that pulse waveform analyses of ocular microcirculation using LSFG may be a useful physiological method for detecting large vascular conditions such as atherosclerotic change.…”

Evaluation of ocular microcirculation in males with metabolic syndrome

“…The MBR has been reported to be in uenced by background and systemic conditions such as age-related changes and sex differences [9][10][11][12]. The pulse waveform parameters of the MBR that are synchronized with the heart rate and reported to be related to systemic vascular function include the blowout score (BOS), the blowout time (BOT), and the rising rate (RR) [13][14][15][16]. For example, associations between the BOS and macrovascular arterial stiffness [13] and left diastolic ventricular function [14] have been reported, while the BOT is associated with arterial stiffness [15] and systemic peripheral vascular resistance [16] and the RR is associated with left ventricular systolic function [14].…”

Novel superpixel method to visualize fundus blood flow resistivity in healthy adults

“…BOS and BOT partly reflect vascular resistance 27 , 28 , but their calculation requires averaging from separate images acquired for each heartbeat, and these parameters are thus strongly influenced by heart rate. Beat strength (BS) over the temporal average of the MBR (BOM) parameter, which does not depend on heart rate, was therefore devised to overcome this drawback.…”

“…Several studies have revealed that age [8][9][10][11] and sex 8-12 are significantly correlated with the average MBR in the ONH. The change in MBR throughout the cardiac cycle is represented by waveform parameters such as blowout score (BOS) [13][14][15][16][17][18] and blowout time (BOT) 14,[19][20][21][22][23][24][25] , which are used to quantify age-dependent increases in resistivity 8 and to assess the relationship between blood flow and resistivity 26 .BOS and BOT partly reflect vascular resistance 27,28 , but their calculation requires averaging from separate images acquired for each heartbeat, and these parameters are thus strongly influenced by heart rate. Beat strength (BS) over the temporal average of the MBR (BOM) parameter, which does not depend on heart rate, was therefore devised to overcome this drawback.…”