Retinal arteriolar narrowing and left ventricular remodeling - The multi-ethnic study of atherosclerosis
Retinal arteriolar narrowing and left ventricular remodeling - The multi-ethnic study of atherosclerosis
复制标题
DOI：
10.1016/j.jacc.2007.03.029
复制
发表时间：
2007-07-03
影响因子：
24
通讯作者：
Wong, Tien Yin
中科院分区：
文献类型：
--
作者：
Cheung, Ning;Bluemke, David A.;Wong, Tien Yin
目的本研究旨在探讨视网膜血管征象与左心室（LV）质量、体积和向心性remodel.Background的关系，微血管疾病反映为视网膜病变，已被证明是临床充血性心力衰竭的预测指标。这些视网膜血管的变化是否与无症状individuals.Methods的心脏早期结构改变和重塑有关，一项横断面，以人群为基础的研究，4,593名年龄在45至85岁的参与者，无临床心血管疾病。视网膜血管口径和视网膜病变根据标准化的协议从视网膜照片进行分级。通过心脏磁共振成像测量LV质量和体积。左室向心性重构的程度由左室质量与舒张末期容积的比值确定结果在控制了年龄、性别、种族、中心、既往和当前收缩压、体重指数、吸烟、抗高血压药物、糖尿病、糖尿病病程、糖化血红蛋白、血脂和C反应蛋白后，较窄的视网膜小动脉口径与向心性（M/V比的最高五分位数）重塑相关（优势比[OR] 2.06，95%置信区间1.57 - 2.70）。这种关联在男性和女性中都有发现，甚至在那些没有糖尿病、没有高血压和没有明显冠状动脉钙化的人中也存在。在多变量分析中，视网膜病变的存在（OR 1.31，95%置信区间1.08至1.61）也与向心性remodel.Conclusions狭窄的视网膜小动脉口径与LV向心性重构独立于传统的危险因素和冠状动脉粥样硬化的负担，支持的假设，微血管疾病可能有助于心脏重构。
Objectives This study sought to examine the relationships of retinal vascular signs with left ventricular (LV) mass, volume, and concentric remodeling.Background Microvascular disease, reflected as retinopatly lesions, has been shown to predict clinical congestive heart failure. Whether these retinal vascular changes are related to early structural alterations and remodeling of the heart in asymptomatic individuals is unknown.Methods A cross-sectional, population-based study of 4,593 participants ages 45 to 85 years, free of clinical cardiovascular disease. Retinal vascular calibers and retinopathy were graded from retinal photographs according to standardized protocols. The LV mass and volume were measured from cardiac magnetic resonance imaging. Extent of LV concentric remodeling was determined by the ratio of LV mass to end-diastolic volume (M/V ratio).Results After controlling for age, gender, race, center, past and current systolic blood pressure, body mass index, smoking, antihypertensive medications, diabetes, diabetes duration, glycosylated hemoglobin, lipid profile, and C-reactive protein, narrower retinal arteriolar caliber was associated with concentric (highest quintile of M/V ratio) remodeling (odds ratio [OR] 2.06, 95% confidence interval 1.57 to 2.70). This association was seen in men and women, and was present even in those without diabetes, without hypertension, and without significant coronary calcification. In multivariate analysis, the presence of retinopathy (OR 1.31, 95% confidence interval 1.08 to 1.61) was also associated with concentric remodeling.Conclusions Narrower retinal arteriolar caliber is associated with LV concentric remodeling independent of traditional risk factors and coronary atherosclerotic burden, supporting the hypothesis that microvascular disease may contribute to cardiac remodeling.