Health Unit, Flemish Institute for Technological Research (VITO), Mol, Belgium; Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium.
Health Unit, Flemish Institute for Technological Research (VITO), Mol, Belgium; Transportation Research Institute, Hasselt University, Hasselt, Belgium.
Microvasc Res. 2019 Jul;124:25-29. doi: 10.1016/j.mvr.2019.02.006. Epub 2019 Feb 23.
Exercise-based rehabilitation improves general cardiovascular fitness. The impact on the microvascular system has been studied in less detail. We measured changes in retinal blood vessel diameters, as a proxy for microvascular reactivity, in cardiac patients and we assessed the impact of a rehabilitation program on retinal vessel diameters.
Cardiac patients (n = 78) and age-matched healthy controls (n = 32) performed an initial maximal endurance cycling test. Patients then participated in a 12-week rehabilitation program with additional endurance tests being performed six and twelve weeks after the initial test.
Fundus images were collected immediately before and 0, 5, 10, 15 and 30 min after the endurance test. Widths of retinal blood vessels, represented as Central Retinal Arteriolar/Venular Equivalent (CRAE/CRVE) were calculated from the images.
At the start of the rehabilitation program, CRAE and CRVE values of the patients changed immediately after the endurance test with respectively -1.90 μm (95% CI: -3.58; -0.22) and -5.32 μm (95% CI: -7.33; -3.30) compared to baseline values. In contrast, CRAE and CRVE values of healthy controls were respectively increased [3.52 μm (95% CI: 2.34; 4.69)] and decreased [-3.17 μm (95% CI: -5.27; -1.07)]. After six and twelve weeks, CRAE responses of patients immediately after endurance test increased respectively with 5.98 μm (95% CI: 4.25; 7.71) and 4.44 μm (95% CI: 3.18; 5.71). These responses were similar to the microvascular reactions observed in the control group.
Arteriolar and venular retinal microvascular responses in cardiac patients were different from the ones of healthy controls. Retinal microvascular response of cardiac patients improved during rehabilitation.
基于运动的康复可以改善整体心血管健康。其对微血管系统的影响尚未得到详细研究。我们测量了心脏患者视网膜血管直径的变化，作为微血管反应的替代指标，并评估了康复计划对视网膜血管直径的影响。
心脏患者（n=78）和年龄匹配的健康对照者（n=32）进行了初始最大耐力自行车测试。然后，患者参加了为期 12 周的康复计划，并在初始测试后 6 周和 12 周进行了额外的耐力测试。
在耐力测试前、测试后 0、5、10、15 和 30 分钟时采集眼底图像。从图像中计算视网膜血管的宽度，用中央视网膜动脉/静脉等效直径（CRAE/CRVE）表示。
在康复计划开始时，患者的 CRAE 和 CRVE 值在耐力测试后立即发生变化，与基线值相比，分别减少了-1.90μm（95%置信区间：-3.58；-0.22）和-5.32μm（95%置信区间：-7.33；-3.30）。相比之下，健康对照组的 CRAE 和 CRVE 值分别增加了[3.52μm（95%置信区间：2.34；4.69）]和减少了[-3.17μm（95%置信区间：-5.27；-1.07）]。在 6 周和 12 周后，患者在耐力测试后立即的 CRAE 反应分别增加了 5.98μm（95%置信区间：4.25；7.71）和 4.44μm（95%置信区间：3.18；5.71）。这些反应与对照组观察到的微血管反应相似。
心脏患者的动脉和静脉视网膜微血管反应与健康对照组不同。心脏患者的视网膜微血管反应在康复过程中得到改善。
