Arnould L, Guenancia C, Gabrielle P-H, Pitois S, Baudin F, Pommier T, Zeller M, Bron A M, Creuzot-Garcher C, Cottin Y
Ophthalmology Department, University Hospital, 14, rue Paul-Gaffarel, 21079 Dijon, France; INSERM, CIC1432, clinical epidemiology unit, Dijon, France; Dijon University Hospital, Clinical investigation Centre, Clinical epidemiology/clinical trials unit, Dijon, France; Centre des sciences du goût et de l'alimentation, Agrosup Dijon, CNRS, INRAE, université Bourgogne Franche-Comté, 21000 Dijon, France.
Cardiology Department, University Hospital, Dijon, France; PEC 2, University Hospital, Dijon, France.
J Fr Ophtalmol. 2020 Mar;43(3):216-221. doi: 10.1016/j.jfo.2019.07.026. Epub 2020 Jan 20.
Quantitative measurements of retinal microvasculature by optical coherence tomography angiography (OCT-A) have been used to assess cardiovascular risk profile. However, to date, there are no studies focusing on OCT-A imaging in the setting of the altered hemodynamic status found in high-risk cardiovascular patients.
To determine the potential association between retinal vascular density on OCT-A and a comprehensive battery of hemodynamic variables in patients with myocardial infarction (MI) using data from the acute phase and at 3 months follow-up after cardiac rehabilitation. This prospective longitudinal study included patients who presented with MI in the cardiology intensive care unit at Dijon University Hospital. Main outcomes and measurements were retinal vessel density on OCT-A, hemodynamic status based on left ventricular ejection fraction (LVEF), and indexed cardiac output during the acute phase of myocardial infarction and at 3 months follow-up.
Overall, 30 patients were included in this pilot study. The median (IQR) age was 64 years (55-71) with 87% men. At admission, the mean (SD) LVEF was 53% (11), and the mean indexed cardiac output was 2.70 (0.83) L/min/m. On OCT-A, the mean inner retinal vascular density was 19.09 (2.80) mm. No significant association was found between retinal vascular density and hemodynamic variables.
We found no significant association between retinal vascular density on OCT-A and hemodynamic variables in the acute phase of a myocardial infarction or after 3 months of cardiac rehabilitation. Therefore, OCT-A findings do not seem to be influenced by the hemodynamic changes associated with myocardial infarction.
光学相干断层扫描血管造影(OCT-A)对视网膜微血管系统进行的定量测量已被用于评估心血管风险状况。然而,迄今为止,尚无研究聚焦于高危心血管患者血流动力学状态改变情况下的OCT-A成像。
利用急性心肌梗死(MI)患者急性期及心脏康复3个月随访的数据,确定OCT-A上视网膜血管密度与一系列全面血流动力学变量之间的潜在关联。这项前瞻性纵向研究纳入了第戎大学医院心内科重症监护病房中出现MI的患者。主要结局和测量指标为MI急性期及3个月随访时OCT-A上的视网膜血管密度、基于左心室射血分数(LVEF)的血流动力学状态以及心指数。
总体而言,30例患者纳入了这项初步研究。中位(四分位间距)年龄为64岁(55 - 71岁),男性占87%。入院时,平均(标准差)LVEF为53%(11),平均心指数为2.7(0.83)L/min/m²。在OCT-A上,视网膜内层血管平均密度为19.09(2.80)mm。未发现视网膜血管密度与血流动力学变量之间存在显著关联。
我们发现在心肌梗死急性期或心脏康复3个月后,OCT-A上的视网膜血管密度与血流动力学变量之间无显著关联。因此,OCT-A的结果似乎不受与心肌梗死相关的血流动力学变化的影响。