Shiba Tomoaki, Takahashi Mao, Matsumoto Tadashi, Hori Yuichi
Department of Ophthalmology, School of Medicine, Toho University, Tokyo, Japan,
Cardiovascular Center, Toho University Sakura Medical Center, Chiba, Japan.
J Vasc Res. 2018;55(6):329-337. doi: 10.1159/000494066. Epub 2018 Nov 8.
To determine: (1) whether variables of a pulse wave form analysis of ocular microcirculation shown by laser speckle flowgraphy (LSFG) correlate with left ventricular (LV) systolic dysfunction and (2) whether these variables correlate with LV diastolic dysfunction in subjects without LV systolic dysfunction as assessed by echocardiography.
We studied 200 consecutive subjects. LV systolic dysfunction has been determined to be present when the LV ejection fraction was < 50%. LV diastolic dysfunction was diagnosed when subjects had an E/e' ratio ≥15 and an e' velocity < 10 cm/s. We evaluated the pulse waveform analysis variables "rising rate" and the blowout score (BOS) using LSFG in the optic nerve head (ONH) and choroid.
The brain natriuretic peptide (BNP) level, the rising rate in the choroid area (rising rate-choroid), and heart rate were revealed as independent factors for LV systolic dysfunction, and BOS-choroid was identified as an independent factor for LV diastolic dysfunction. The areas under the curve (AUC) of BNP and rising rate-choroid for LV systolic dysfunction were 0.83 and 0.81, respectively. The AUC of BOS-choroid for LV diastolic dysfunction was 0.73.
Pulse waveform analysis in the choroid has a significant correlation with LV systolic and LV diastolic function.
确定：（1）激光散斑血流图（LSFG）所示的眼微循环脉搏波形分析变量是否与左心室（LV）收缩功能障碍相关；（2）在经超声心动图评估无LV收缩功能障碍的受试者中，这些变量是否与LV舒张功能障碍相关。
我们研究了200名连续受试者。当LV射血分数<50%时，确定存在LV收缩功能障碍。当受试者的E/e'比值≥15且e'速度<10 cm/s时，诊断为LV舒张功能障碍。我们使用LSFG对视神经乳头（ONH）和脉络膜评估脉搏波形分析变量“上升速率”和扩张评分（BOS）。
脑钠肽（BNP）水平、脉络膜区域的上升速率（上升速率-脉络膜）和心率被揭示为LV收缩功能障碍的独立因素，BOS-脉络膜被确定为LV舒张功能障碍的独立因素。LV收缩功能障碍的BNP和上升速率-脉络膜的曲线下面积（AUC）分别为0.83和0.81。LV舒张功能障碍的BOS-脉络膜的AUC为0.73。
脉络膜中的脉搏波形分析与LV收缩和舒张功能有显著相关性。
