Vascular retinopathy predictive role in long-term appearance of myocardial perfusion defects assessed by SPECT

Abstract

Funding Acknowledgements Type of funding sources: None. Introduction There is little evidence of the association between the different types and degrees of retinopathy and long-term appearance of myocardial perfusion defects assessed by SPECT in patients with suspected ischemic heart disease. Methods Prospective study of 107 patients (75.19 ± 11.53 years; 60.7% male) from a cohort (median follow-up 9.9 years) who underwent coronary angiography and a fundus photography. The myocardial perfusion defects were evaluated by SPECT. Results Baseline characteristics were 60.7% men, 78.5% hypertensive, 32.7% diabetic, and 57% dyslipidemic patients. Retinopathy types were: diabetic: 0.9%, hypertensive 3.7%, atherosclerotic 1.9%, hypertensive-atherosclerotic 70.1%, and all types 8.4% SYNTAX score in coronary angiography was 3.99 ± 7.5. During follow-up, male (p = 0.017) and higher SYNTAX score (p = 0.086) were more frequently associated with pathological myocardial SPECT. In the long term, patients with advanced hypertensive retinopathy (p = 0.012) and atherosclerotic retinopathy (p = 0.027) have perfusion defects more frequently. Male sex (OR 4.13; 95% CI: 0.85-20.14) and grade ≥2 atherosclerotic retinopathy (OR: 2.2. 95% CI: 0.7-7) showed in multivariate analysis a trend as high risk predictors of myocardial perfusion defects. Conclusions Hypertensive and atherosclerotic retinopathy were associated with long-term myocardial perfusion defects. The performance of the fundus as part of the cardiovascular risk study is an useful tool that allows identifying higher risk patients.