Microvascular reactivity in rehabilitating cardiac patients based on measurements of retinal blood vessel diameters

Louwies, Tijs; Panis, Luc Int; Alders, Toon; Bonne, Kim; Goswami, Nandu; Nawrot, Tim S.; Dendale, Paul; Boever, Patrick De

doi:10.1016/j.mvr.2019.02.006

Cited by 12 publications

(14 citation statements)

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“…retinal arteriolar dilatation and venular constriction) and functionality of the microvasculature in subjects with microvascular diseases and physically inactive adults 28,53,54 . To date, only few studies evaluated the effects of different exercise modalities on microvasculature 29,55,56 . In patients with migraine and patients with unipolar depression it has been demonstrated that high-intensity interval training is slightly more effective in improving microvascular structure and www.nature.com/scientificreports www.nature.com/scientificreports/ function than moderate, continuous exercise 55,56 .…”

Section: Discussionmentioning

confidence: 99%

“…In addition, we aimed to determine the effects of an exercise-based pulmonary rehabilitation program on retinal vessel diameters in patients with COPD. Based on earlier work, demonstrating that regular exercise can induce retinal arteriolar dilatation and venular constriction in healthy adults 28,29 , we hypothesized that regular exercise training can change the dimensions of retinal vessel diameters in these patients and hence provide support for improved microcirculatory status as a result of regular exercise.…”

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confidence: 99%

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Structural analysis of retinal blood vessels in patients with COPD during a pulmonary rehabilitation program

Vaes

Spruit

Keer

et al. 2020

Sci Rep

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cardiovascular diseases are frequently present in chronic obstructive pulmonary disease (copD). population-based studies found associations between retinal vessel diameters and cardiovascular health, but it is unknown whether this also applies to COPD patients. Therefore, we measured retinal vessel diameters in copD patients and aimed to determine the association with cardiovascular risk factors, lung function, and functional outcomes. In addition, we investigated whether an exercisebased pulmonary rehabilitation (PR) program would change retinal vessel diameters, as a proxy for improved microvascular health. Demographics and clinical characteristics, including pulmonary function, exercise capacity, blood pressure, blood measurements and level of systemic inflammation were obtained from 246 patients during routine assessment before and after PR. Retinal vessel diameters were measured from digital retinal images. older age and higher systolic blood pressure were associated with narrower retinal arterioles (β: −0.224; p = 0.042 and β: −0.136; p < 0.001, respectively). Older age, higher systolic blood pressure and lower level of systemic inflammation were associated with narrower retinal venules (β: −0.654; −0.229; and −13.767, respectively; p < 0.05). No associations were found between retinal vessel diameters and lung function parameters or functional outcomes. After PR, no significant changes in retinal venular or arteriolar diameter were found. To conclude, retinal vessel diameters of COPD patients were significantly associated with systolic blood pressure and systemic inflammation, whilst there was no evidence for an association with lung function parameters, functional outcomes or other cardiovascular risk factors. Furthermore, an exercise-based PR program did not affect retinal vessel diameter. Chronic obstructive pulmonary disease (COPD) is characterized by persistent respiratory symptoms and airflow limitation due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases 1. Although the diagnosis of COPD is based on spirometry, it is well recognized that COPD is associated with a range of systemic extrapulmonary effects 1. Indeed, comorbidities are frequently present and contribute to the severity of disease 2-4. Cardiovascular disease (including hypertension, coronary artery disease, congestive heart failure, stroke and peripheral arterial disease) is a common comorbidity in COPD 2,5. Smoking is the most important risk factor for the development of COPD, but it is also a major risk factor for the development of cardiovascular disease 6,7. Indeed, cigarette smoke not only affects the airway epithelium, but also causes vascular endothelial damage and loss of microvascular integrity in several organs, including the heart, brain, and kidney 8,9. In addition, systemic inflammatory processes, oxidative stress, and hypoxia may contribute

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Structural analysis of retinal blood vessels in patients with COPD during a pulmonary rehabilitation program

Vaes

Spruit

Keer

et al. 2020

Sci Rep

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“…Retinal imaging analysis is a procedure which enables us to visualize the microcirculation in the eye consisting of blood vessels that are less than ~ 150 μm and include the smallest resistance vessels. They form an important part of our circulatory system and assessment of these retinal microvasculature can provide an indication of cardiovascular health [ 40 , 53 ]. Several studies have reported that there is a connection between changes in retinal microvasculature and coronary heart disease [ 54 ].…”

Section: Methodsmentioning

confidence: 99%

COVID-19 and its effects on endothelium in HIV-positive patients in sub-Saharan Africa: Cardiometabolic risk, thrombosis and vascular function (ENDOCOVID STUDY)

et al. 2021

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Background COVID-19 has affected almost every country in the world, especially in terms of health system capacity and economic burden. People from sub-Saharan Africa (SSA) often face interaction between human immunodeficiency virus (HIV) infection and non-communicable diseases such as cardiovascular disease. Role of HIV infection and anti-retroviral treatment (ART) in altered cardiovascular risk is questionable and there is still need to further carry out research in this field. However, thus far it is unclear, what impact the COVID-19 co-infection in people living with HIV (PLHIV), with or without therapy will have. The ENDOCOVID project aims to investigate whether and how HIV-infection in COVID-19 patients modulates the time course of the disease, alters cardiovascular risk, and changes vascular endothelial function and coagulation parameters/ thrombosis risk. Methods A total of 1026 patients will be included into this study. Cardiovascular research PLHIV with (n = 114 in each of the three recruiting centers) - or without - ART (n = 114 in each of the three recruiting centers) with COVID-19 and HIV-negative with COVID-19 (n = 114 in each of the three recruiting centers) will be carried out via clinical and biochemical measurements for cardiovascular risk factors and biomarkers of cardiovascular disease (CVD). Vascular and endothelial function will be measured by brachial artery flow-mediated dilatation (FMD), carotid intima-media thickness (IMT) assessments, and retinal blood vessel analyses, along with vascular endothelial biomarkers and cogualation markers. The correlation between HIV-infection in COVID-19 PLHIV with or without ART and its role in enhancement of cardiovascular risk and endothelial dysfunction will be assessed at admission, weekly, at discharge and, 4 weeks post-discharge (if possible). Impact of project The ENDOCOVID project aims to evaluate in the long-term the cardiovascular risk and vascular endothelial function in PLHIV thus revealing an important transitional cardiovascular phenotype in COVID-19. The study was registered under clinicaltrials.gov (NCT04709302).

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“…In unhealthy persons, who often have low levels of NO, no increases in vascular diameter are seen when the arterial occlusion is released. The gold standard of noninvasive endothelial function testing is FMD of the brachial artery [ 163 , 164 , 165 ]. As the FMD measurements are operator-dependent, strict physiological and methodological should be used [ 166 , 167 , 168 , 169 ].…”

Section: Measurements (Assessment) Of Vascular Functionmentioning

confidence: 99%

“…The measure of intima-media thickness is an easy way to find endothelial dysfunction [ 172 ]. As in normal endothelium, there is no plaque, and the average thickness on intima-media is 0.9 mm [ 164 ], but when the endothelium does not function well and becomes unhealthy, there is an increase in its thickness, and atheromatous plaque forms [ 173 ]. Carotid or femoral artery can easily accept big arteries for detecting either plaque or thickness of intima-media by ultrasound device.…”

Section: Measurements (Assessment) Of Vascular Functionmentioning

confidence: 99%

Autoimmune Rheumatic Diseases and Vascular Function: The Concept of Autoimmune Atherosclerosis

Hedar

Stradner

Roessler

et al. 2021

JCM

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Autoimmune rheumatic diseases (AIRDs) with unknown etiology are increasing in incidence and prevalence. Up to 5% of the population is affected. AIRDs include rheumatoid arthritis, system lupus erythematosus, systemic sclerosis, and Sjögren’s syndrome. In patients with autoimmune diseases, the immune system attacks structures of its own body, leading to widespread tissue and organ damage, which, in turn, is associated with increased morbidity and mortality. One third of the mortality associated with autoimmune diseases is due to cardiovascular diseases. Atherosclerosis is considered the main underlying cause of cardiovascular diseases. Currently, because of finding macrophages and lymphocytes at the atheroma, atherosclerosis is considered a chronic immune-inflammatory disease. In active inflammation, the liberation of inflammatory mediators such as tumor necrotic factor alpha (TNFa), interleukine-6 (IL-6), IL-1 and other factors like T and B cells, play a major role in the atheroma formation. In addition, antioxidized, low-density lipoprotein (LDL) antibodies, antinuclear antibodies (ANA), and rheumatoid factor (RF) are higher in the atherosclerotic patients. Traditional risk factors like gender, age, hypercholesterolemia, smoking, diabetes mellitus, and hypertension, however, do not alone explain the risk of atherosclerosis present in autoimmune diseases. This review examines the role of chronic inflammation in the etiology—and progression—of atherosclerosis in autoimmune rheumatic diseases. In addition, discussed here in detail are the possible effects of autoimmune rheumatic diseases that can affect vascular function. We present here the current findings from studies that assessed vascular function changes using state-of-the-art techniques and innovative endothelial function biomarkers.

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Microvascular reactivity in rehabilitating cardiac patients based on measurements of retinal blood vessel diameters

Cited by 12 publications

References 28 publications

Structural analysis of retinal blood vessels in patients with COPD during a pulmonary rehabilitation program

Structural analysis of retinal blood vessels in patients with COPD during a pulmonary rehabilitation program

COVID-19 and its effects on endothelium in HIV-positive patients in sub-Saharan Africa: Cardiometabolic risk, thrombosis and vascular function (ENDOCOVID STUDY)

Autoimmune Rheumatic Diseases and Vascular Function: The Concept of Autoimmune Atherosclerosis

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