The relationship between aortic stiffness and changes in retinal microvessels among Asian ischemic stroke patients

Silva, D A De; Woon, F-P; Manzano, J J; Liu, E Y; Chang, Hyo Won; Chen, C; Wang, J J; Mitchell, Paul; Kingwell, Bronwyn A.; Cameron, J.; Lindley, Richard I.; Wong, Tien Yin; Wong, Mark Yu Zheng

doi:10.1038/jhh.2011.88

Cited by 24 publications

(15 citation statements)

References 38 publications

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“…Of the retinal vascular measures, retinal arteriolar caliber was most consistently associated with PWV in adults with cardiometabolic disorders. In these patients, narrower (worse) retinal arteriolar caliber was consistently and modestly correlated with higher (worse) PWV (correlation coefficient ( r ) range from −0.21 to −0.23, Table ) . This effect was only observed in one of three adult general population studies that compared extreme values using categorical variables .…”

Section: Resultsmentioning

confidence: 94%

“…In these patients, narrower (worse) retinal arteriolar caliber was consistently and modestly correlated with higher (worse) PWV (correlation coefficient (r) range from −0.21 to −0.23, Table 2). 18,45,49,50 This effect was only observed in one of three adult general population studies that compared extreme values using categorical variables. 41 In children who were six years of age, there was little evidence of an association.…”

Section: Associations Of Retinal Microvascular Caliber With Functiomentioning

confidence: 99%

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Associations of retinal microvascular caliber with intermediate phenotypes of large arterial function and structure: A systematic review and meta‐analysis

et al. 2019

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Objective Intermediate phenotypes of microcirculation (retinal microvascular caliber) are associated with cardiovascular (CV) risk factors and independently predict CV events. However, the effect of microcirculation variation on the vascular system is unclear. We conducted a systematic review and meta‐analysis of observational studies to quantify associations of retinal microvascular caliber (arteriolar, venular caliber, arteriole‐to‐venule ratio) and preclinical CV measures (large arterial function and structure). Methods We identified studies in MEDLINE, EMBASE, and PubMed (1946 to March 2018) studying (a) general population samples and (b) patients with cardiometabolic disease. Study‐specific correlation estimates were combined into meta‐analysis where possible. Results Of 1294 studies identified, 26 met inclusion criteria (general population 16, patients 10), of which five studies were included in meta‐analysis. Most studied middle‐aged adults cross‐sectionally, with one childhood study. Large arterial function and structure were predominantly assessed by pulse wave velocity and carotid intima‐media thickness, respectively. Only arteriolar caliber was consistently associated with arterial function and structure, with stronger associations observed in cardiometabolic patients. Narrower (worse) arteriolar caliber was associated with faster (poorer) pulse wave velocity (correlation coefficient (r) −0.17, 95% CI −0.25 to −0.10) and greater (poorer) intima‐media thickness (r −0.05, 95%CI −0.09 to −0.02) across all adult participants. Conclusions Retinal arteriolar, but not venular caliber, was modestly associated with large arterial function and weakly associated with large arterial structure, with stronger evidence in patients with cardiometabolic disease. This suggests that preclinical changes in large arteries and the microcirculation have some shared but mainly unique pathways to associate with cardiovascular disease.

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Section: Resultsmentioning

confidence: 94%

Section: Associations Of Retinal Microvascular Caliber With Functiomentioning

confidence: 99%

Associations of retinal microvascular caliber with intermediate phenotypes of large arterial function and structure: A systematic review and meta‐analysis

et al. 2019

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“…The correlation between the arterial stiffness and the retinal microvascular changes has been recently proved in clinical trials. [27][28][29][30] However, the mechanisms underlying the correlation remain unclear. Changes in the structure and the blood flow velocity of the arteriole or the microvascular structures carrying nutrients may affect the aortic function.…”

Section: Discussionmentioning

confidence: 99%

“…[27][28][29][30] However, the association of microvascular complexity and microcirculatory damage as a measure of retinal vascular fractal dimension in aortic stiffness has yet to be elucidated. Therefore, to evaluate the correlation between aortic stiffness and microvascular lesions, we designed this cross-sectional study to investigate the association of CRAE and retinal vascular fractal dimension with aortic stiffness in a Chinese population.…”

Section: Introductionmentioning

confidence: 99%

Aortic stiffness is associated with the central retinal arteriolar equivalent and retinal vascular fractal dimension in a population along the southeastern coast of China

et al. 2015

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The objective of this study was to evaluate the association of the central retinal arteriolar equivalent (CRAE) and the retinal vascular fractal dimension, two quantitative parameters that reflect microcirculation, with aortic stiffness. In this cross-sectional study, we identified the cardiovascular risk factors in 2169 subjects using a health questionnaire, physical examinations and laboratory examinations. We evaluated the aortic stiffness using noninvasive brachial-ankle pulse wave velocity (baPWV) and assessed the microcirculatory alterations with CRAE and retinal vascular fractal dimension, which were measured using fundus photography and semiautomatic quantitative software, respectively. The increase in baPWV (Q1-Q4) correlated with an increased likelihood of the central retinal artery narrowing and a reduction in the retinal vascular fractal dimension. Further adjustment of the cardiovascular risk factors diminished the association between baPWV and CRAE, but increased the association between baPWV and retinal vascular fractal dimension. Elevated baPWV correlates with reduced CRAE and retinal vascular fractal dimension. Such a finding supports macrocirculation- and microcirculation-associated hypotheses.

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“…These advantageous characteristics make the retina an ideal window to study not only ocular but also vascular related pathogenesis. Prior studies have provided strong evidence for retinal vascular changes in association with different types of disease including stroke [15], dementia [16], Alzheimer's disease [17], hypertension [18], aortic stiffness [19], diabetes [13], glaucoma [20], and sleep apnea [21]. In particular, retinal arteriolar narrowing, widening of retinal veins, and arteriovenous nipping are hypertensive retinopathy signs which have been evidenced to correlate with cardiovascular events [22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Pressure Dependency of Retinal Arterial Pulse Wave Velocity in the Rat

Rezaeian¹,

Georgevsky²,

Golzan³

et al. 2020

Artery Res

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KeywordsRetinal artery small vessel arterial stiffness pressure dependence pulse wave velocity A B S T R A C TPurpose: The retinal vasculature provides unique in vivo access to the microcirculation and presents the possibility of measuring small artery (retinal) stiffness using pulse wave velocity (PWV). This study investigates whether retinal artery PWV (rPWV) has a blood pressure (BP) dependency.Methods: Fundus videos from eight Sprague-Dawley rats aged 12 weeks were captured (Zeiss fundus microscope with high-speed camera, 125 fps, Optronis, Germany) simultaneously with aortic BP. Retinal artery diameter waveforms at proximal and distal sites were extracted and transit time calculated from the phase delay between frequency components (4-6 Hz, typical heart rate of rats) of the waveforms. rPWV was measured across a physiological range of mean arterial pressure (MAP): baseline (90-110 mmHg); 130 mmHg to baseline following systemic phenylephrine (PE) infusion (30 mg/kg/min); 130 mmHg to baseline during PE infusion with simultaneous inferior vena cava occlusion (VO); 70 mmHg to baseline following systemic sodium nitroprusside infusion; and 70 mmHg to baseline following VO. The correlation between retinal artery rPWV and BP was quantified. Results:There was a significant positive correlation between retinal artery rPWV and MAP as expected (0.19 mm/s/mmHg, R 2 = 0.59, p < 0.001). There was a positive correlation between retinal and aortic PWV (R 2 = 0.09, p = 0.03). Conclusion:The pressure dependency of the measured rPWV indicates the measure has utility in in vivo quantification of the impact on microvessels of cardiovascular diseases. To elucidate the predictive value of screening rPWV in systemic cardiovascular abnormalities, the relation needs to be investigated in humans.

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The relationship between aortic stiffness and changes in retinal microvessels among Asian ischemic stroke patients

Cited by 24 publications

References 38 publications

Associations of retinal microvascular caliber with intermediate phenotypes of large arterial function and structure: A systematic review and meta‐analysis

Associations of retinal microvascular caliber with intermediate phenotypes of large arterial function and structure: A systematic review and meta‐analysis

Aortic stiffness is associated with the central retinal arteriolar equivalent and retinal vascular fractal dimension in a population along the southeastern coast of China

Pressure Dependency of Retinal Arterial Pulse Wave Velocity in the Rat

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