Lumen narrowing and increased wall to lumen ratio of retinal microcirculation are valuable biomarkers of hypertension-mediated cardiac damage
Creators: name: Dąbrowska, Edyta
name: Harazny, Joanna M.
name: Miszkowska-Nagórna, Eliza
name: Stefański, Adrian
name: Graff, Beata
name: Kunicka, Katarzyna
name: Świerblewska, Ewa
name: Rojek, Agnieszka
name: Szyndler, Anna
name: Wolf, Jacek
name: Gruchała, Marcin
name: Schmieder, Roland E.
name: Narkiewicz, Krzysztof
Publisher: name: Taylor & Francis
Year: 2019
Subjects: subject: Space Science
subject: Medicine
subject: Neuroscience
subject: Physiology
subject: FOS: Biological sciences
subject: FOS: Biological sciences
subject: 59999 Environmental Sciences not elsewhere classified
subject: FOS: Earth and related environmental sciences
subject: FOS: Earth and related environmental sciences
subject: Ecology
subject: Immunology
subject: FOS: Clinical medicine
subject: FOS: Clinical medicine
subject: Developmental Biology

description: <b>Purpose:</b> In the course of hypertension, left ventricular hypertrophy and diastolic dysfunction develop very often and may progress toward heart failure. The aim of the study was to analyze the relationship between abnormalities of retinal microcirculation and cardiac damage defined as left ventricular hypertrophy and/or diastolic dysfunction. <b>Materials and methods:</b> The study comprised 88 patients with essential hypertension. The group was divided into two subgroups: hypertensives without cardiac damage (<i>n</i> = 55) and with cardiac damage (<i>n</i> = 33). Control group comprised 32 normotensive subjects. Scanning laser Doppler flowmetry was used to evaluate retinal microcirculation. Echocardiography was used to assess cardiac damage. <b>Results:</b> Lumen diameter of retinal arterioles was significantly smaller in patients with cardiac damage vs. controls (77 vs. 84 µm, <i>p</i> = 0.02). Additionally, there was an evident trend with respect to lumen diameter (LD) across all three studied subgroups; i.e.: the smallest dimeters were present in cardiac damage patients, moderate size in hypertensives’ without cardiac damage, and the largest diameters in healthy controls (<i>p</i><sub>for trend</sub> R = –0.25, <i>p</i> = 0.02), left ventricular mass (<i>R</i> = –0.24, <i>p</i> = 0.02), and left atrial volume (<i>R</i> = –0.22, <i>p</i> = 0.04). Wall to lumen ratio was associated with intraventricular septum diameter (<i>R</i> = 0.21, <i>p</i> = 0.044) and left atrial volume (<i>R</i> = 0.21, <i>p</i> = 0.045). In multivariable regression analysis, lumen diameter was independently associated with intraventricular septum diameter (<i>β</i> = –0.05, <i>p</i> = 0.03), left ventricular mass (<i>β</i> = –1.15, <i>p</i> = 0.04), and left atrial volume (<i>β</i> = –0.42, <i>p</i> = 0.047); wall to lumen ratio was independently associated with intraventricular septum diameter (<i>β</i> = 3.67, <i>p</i> = 0.02) and left atrial volume (<i>β</i> = 30.0, <i>p</i> = 0.04). <b>Conclusions:</b> In conclusion, retinal arterioles lumen diameter and wall to lumen ratio were independent biomarkers of cardiac damage. Retinal examination performed by means of scanning laser Doppler flowmetry might be a valuable tool to improve cardiovascular risk stratification of hypertensive patients.