Association of retinal microvascular density and complexity with incident coronary heart disease

Fu, Yang Xin; Yusufu, Mayinuer; Wang, Yueye; He, Mingguang; Shi, Danli; Wang, Ruobing

doi:10.1016/j.atherosclerosis.2023.117196

Cited by 7 publications

(7 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Lower blood vessel complexity was associated with an increased risk of all-cause mortality and premature mortality, consistent with previous studies showcasing an independent association with cardiovascular and cerebrovascular risk factors, events, and deaths. 10 , 14 , 31 , 32 Previously, risk factors for mortality such as aging and increased blood pressure have been related to reduced retinal vascular branching complexity. 33 , 34 This lower complexity may indicate the presence of endothelium dysfunction, causing dysregulation of vascular bifurcation 35 and consequently reducing the efficiency of vascular networks.…”

Section: Discussionmentioning

confidence: 99%

Retinal Vascular Measurements and Mortality Risk: Evidence From the UK Biobank Study

Yusufu,

Chen,

Dayimu

et al. 2024

Trans. Vis. Sci. Tech.

Self Cite

View full text Add to dashboard Cite

Purpose This study aimed to investigate the association between quantitative retinal vascular measurements and the risk of all-cause and premature mortality. Methods In this population-based cohort study using the UK Biobank data, we employed the Retina-based Microvascular Health Assessment System to assess fundus images for image quality and extracted 392 retinal vascular measurements per fundus image. These measurements encompass six categories of vascular features: caliber, density, length, tortuosity, branching angle, and complexity. Univariate Cox regression models were used to identify potential indicators of mortality risk using data on all-cause and premature mortality from death registries. Multivariate Cox regression models were then used to test these associations while controlling for confounding factors. Results The final analysis included 66,415 participants. After adjusting for demographic, health, and lifestyle factors and genetic risk score, 18 and 10 retinal vascular measurements were significantly associated with all-cause mortality and premature mortality, respectively. In the fully adjusted model, the following measurements of different vascular features were significantly associated with all-cause mortality and premature mortality: arterial bifurcation density (branching angle), number of arterial segments (complexity), interquartile range and median absolute deviation of arterial curve angle (tortuosity), mean and median values of mean pixel widths of all arterial segments in each image (caliber), skeleton density of arteries in macular area (density), and minimum venular arc length (length). Conclusions The study revealed 18 retinal vascular measurements significantly associated with all-cause mortality and 10 associated with premature mortality. Those identified parameters should be further studied for biological mechanisms connecting them to increased mortality risk. Translational Relevance This study identifies retinal biomarkers for increased mortality risk and provides novel targets for investigating the underlying biological mechanisms.

show abstract

Section: Discussionmentioning

confidence: 99%

Retinal Vascular Measurements and Mortality Risk: Evidence From the UK Biobank Study

Yusufu,

Chen,

Dayimu

et al. 2024

Trans. Vis. Sci. Tech.

Self Cite

View full text Add to dashboard Cite

show abstract

“…The high incidence and mortality rates of CAD imply early detection, and intervention are imperative. Fu et al used deep learning technology to quantify retinal vascular parameters from color fundus photography of 57,947 participants without CAD; after approximately 11 years of follow-up, the FD of blood vessels had decreased, and the reduction in the number of arterial and small venous segments and arterial and venous bone densities was closely associated with an increased risk of subsequent CAD ( Fu et al, 2023 ). Hence, detecting retinal vascular parameters could help predict CAD ( Shokr et al, 2021 ).…”

Section: Clinical Research and Applications In Systemic Diseasesmentioning

confidence: 99%

“…Quantitative research on retinal blood vessels could provide insights into the conditions of cardiovascular, cerebrovascular, and systemic blood vessels because they are components of the body’s circulatory system ( Dumitrascu and Koronyo-Hamaoui, 2020 ). The AI-based retinal vessel quantification technology can help clinicians and researchers study ocular and systemic diseases, benefiting disease prevention, diagnosis, and treatment ( Gadde et al, 2016 ; Fuchs et al, 2022 ; Fu et al, 2023 ). A few articles have reviewed this technology; however, summarizing its recent progress is still needed.…”

Section: Introductionmentioning

confidence: 99%

Progress in clinical research and applications of retinal vessel quantification technology based on fundus imaging

Chen,

Zhu,

Yang

et al. 2024

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

Retinal blood vessels are the only directly observed blood vessels in the body; changes in them can help effective assess the occurrence and development of ocular and systemic diseases. The specificity and efficiency of retinal vessel quantification technology has improved with the advancement of retinal imaging technologies and artificial intelligence (AI) algorithms; it has garnered attention in clinical research and applications for the diagnosis and treatment of common eye and related systemic diseases. A few articles have reviewed this topic; however, a summary of recent research progress in the field is still needed. This article aimed to provide a comprehensive review of the research and applications of retinal vessel quantification technology in ocular and systemic diseases, which could update clinicians and researchers on the recent progress in this field.

show abstract

“…It is characterized by chronic inflammation of the blood vessels. Non-invasive analysis of retinal microvasculature can reveal significant dysfunction of vessels, and has the potential to predict cardiovascular events in the general population [53]. Fu Y et al performed a study on 57,947 participants without a history of CVD that were followed for a period of 11 years.…”

Section: Retinal Vascular Changes and Heart Diseasementioning

confidence: 99%

Non-Invasive Retinal Vessel Analysis as a Predictor for Cardiovascular Disease

Iorga,

Costin,

Munteanu-Dănulescu

et al. 2024

JPM

View full text Add to dashboard Cite

Cardiovascular disease (CVD) is the most frequent cause of death worldwide. The alterations in the microcirculation may predict the cardiovascular mortality. The retinal vasculature can be used as a model to study vascular alterations associated with cardiovascular disease. In order to quantify microvascular changes in a non-invasive way, fundus images can be taken and analysed. The central retinal arteriolar (CRAE), the venular (CRVE) diameter and the arteriolar-to-venular diameter ratio (AVR) can be used as biomarkers to predict the cardiovascular mortality. A narrower CRAE, wider CRVE and a lower AVR have been associated with increased cardiovascular events. Dynamic retinal vessel analysis (DRVA) allows the quantification of retinal changes using digital image sequences in response to visual stimulation with flicker light. This article is not just a review of the current literature, it also aims to discuss the methodological benefits and to identify research gaps. It highlights the potential use of microvascular biomarkers for screening and treatment monitoring of cardiovascular disease. Artificial intelligence (AI), such as Quantitative Analysis of Retinal vessel Topology and size (QUARTZ), and SIVA–deep learning system (SIVA-DLS), seems efficient in extracting information from fundus photographs and has the advantage of increasing diagnosis accuracy and improving patient care by complementing the role of physicians. Retinal vascular imaging using AI may help identify the cardiovascular risk, and is an important tool in primary cardiovascular disease prevention. Further research should explore the potential clinical application of retinal microvascular biomarkers, in order to assess systemic vascular health status, and to predict cardiovascular events.

show abstract

Association of retinal microvascular density and complexity with incident coronary heart disease

Cited by 7 publications

References 32 publications

Retinal Vascular Measurements and Mortality Risk: Evidence From the UK Biobank Study

Retinal Vascular Measurements and Mortality Risk: Evidence From the UK Biobank Study

Progress in clinical research and applications of retinal vessel quantification technology based on fundus imaging

Non-Invasive Retinal Vessel Analysis as a Predictor for Cardiovascular Disease

Contact Info

Product

Resources

About