Association between Retinal Arteriolar and Venule Calibre with Prevalent Heart Failure: A Cross-Sectional Study

Abstract

BackgroundThere is evidence to suggest that microvascular disease, particularly diabetic retinopathy, plays a role in the pathogenesis of HF. However, whether changes in retinal vessel calibre predicts HF is unclear. The purpose of this study was to examine the association of retinal microvascular structure with prevalent heart failure (HF).MethodsThe Australian Heart Eye Study (AHES) is a cross-sectional study that surveyed 1680 participants who presented to a tertiary referral hospital for the evaluation of potential coronary artery disease by coronary angiography. Retinal vessel calibre was graded using retinal photography and participants’ self-reported echocardiography-confirmed HF was obtained via an extensive medical questionnaire.ResultsThere were 107 participants (8.1%) with prevalent self-reported HF. Persons with wider retinal arteriolar calibre (comparing highest versus lowest tertile or reference) were more likely to have prevalent HF (OR 3.5; 95% CI, 1.7–7.2) when adjusted for age and sex. After further adjustment for body mass index, hypertension, diabetes, smoking status, triglycerides and estimated glomerular filtration rate, this association remained significant (OR 4.5; 95% CI, 2.0–9.8). After further stratification, this association remained significant among participants with diabetes (OR 10.3; 95% CI, 2.7–39.3) but not in those without diabetes (OR 2.7; 95% CI, 0.9–7.5). The strength of this association was not dependent on the length of history of diabetes, or retinopathy status. There was no significant association between retinal venular calibre and prevalence of HF.ConclusionsWider retinal arteriolar diameter was significantly and independently associated with prevalent HF in participants of a cross-sectional study. This association was significant stronger among participants with diabetes compared to without diabetes. No association was found between retinal venule calibre with prevalent HF.

The eyes are the mirror of the heart: role of retinal microvascular abnormalities in predicting long‐term risk of heart failure

“…The population‐based Australian Heart Eye Study (AHES) reported a significant association between wider retinal arterioles and prevalent HF, independent of the traditional risk factors . This association appeared stronger in patients with diabetes compared with those without diabetes . In contrast to the present study by Chandra et al ., no association was observed between wider retinal venules and HF, for reasons that remain unexplained.…”

“…9 This association appeared stronger in patients with diabetes compared with those without diabetes. 9 In contrast to the present study by Chandra et al, 10 no association was observed between wider retinal venules and HF, for reasons that remain unexplained. In addition, in the same Australian cohort, no association was observed between the magnitude of age-related macular degeneration and prevalent HF.…”

“…The association between retinal microvascular abnormalities and HF has been explored in a minority of clinical and population‐based studies, with ostensibly conflicting results. The population‐based Australian Heart Eye Study (AHES) reported a significant association between wider retinal arterioles and prevalent HF, independent of the traditional risk factors . This association appeared stronger in patients with diabetes compared with those without diabetes .…”

The Association Between Retinal Vessel Abnormalities and H-type Hypertension

“…As we all know, hypertension can cause small vascular lesions throughout the body, especially the retinal vessels. Recently, many studies have already investigated in the relationship between HCY and cardiovascular or cerebrovascular diseases [1][2][3]. Retinal vessels are the only visible microvascular in the human body.…”

Cardiovascular diseases: what else should cardiologists know?

“…Recently a close attention was paid on the retinal microvasculature [2] and it's visualization in patients with CVD [3][4][5][6][7][8]. The retina is the only place in whole human organism, where are visible vessels of alive person, reflecting early changes in other organs.…”