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视网膜静脉阻塞患者的内皮功能障碍和动脉壁功能障碍。

Endothelial dysfunction and impaired arterial wall properties in patients with retinal vein occlusion.

机构信息

2nd Department of Ophthalmology, National and Kapodistrian University of Athens Medical School, Athens, Greece.

1st Department of Cardiology, National and Kapodistrian University of Athens Medical School, Hippokration Hospital, Athens, Greece.

出版信息

Vasc Med. 2020 Aug;25(4):302-308. doi: 10.1177/1358863X20913609. Epub 2020 Apr 20.

DOI:10.1177/1358863X20913609
PMID:32308146
Abstract

Retinal vein occlusion (RVO) is a common retinal vascular lesion, and a leading cause of visual impairment. Patients with RVO have an increased risk for cardiovascular disease and share multiple common risk factors. In this study, we investigated the endothelial function and arterial stiffness of patients with RVO compared to healthy-control (CL) subjects. We enrolled 40 consecutive patients with RVO and 40 CL subjects. RVO was diagnosed by an ophthalmologist, endothelial function was evaluated by flow mediated dilation (FMD) in the brachial artery, and carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx) of the radial artery were measured to evaluate arterial stiffness and reflected waves, respectively. No significant differences were detected between the studied groups in sex, age, presence of hypertension or dyslipidemia, body mass index, systolic and diastolic blood pressure levels, total cholesterol levels, and smoking habits ( > 0.05 for all). However, patients with RVO had impaired FMD ( = 0.002) and increased PWV ( = 0.004), even after adjustment for several confounders. Both FMD and PWV were also significantly and independently associated with the development of RVO. Furthermore, a significant and positive correlation between PWV and systolic blood pressure existed only in the CL group. Therefore, we have shown that RVO is associated with significant endothelial dysfunction and increased arterial stiffness. Our results strengthen the vascular theory, according to which, systemic endothelial dysfunction and arteriosclerosis play a significant role in the pathogenesis of RVO.

摘要

视网膜静脉阻塞(RVO)是一种常见的视网膜血管病变,也是视力损害的主要原因。RVO 患者心血管疾病的风险增加,并且有多种共同的危险因素。在这项研究中,我们比较了 RVO 患者和健康对照组(CL)患者的内皮功能和动脉僵硬度。我们纳入了 40 名连续的 RVO 患者和 40 名 CL 对照者。眼科医生诊断 RVO,通过肱动脉血流介导的扩张(FMD)评估内皮功能,测量颈动脉-股动脉脉搏波速度(PWV)和桡动脉增强指数(AIx)分别评估动脉僵硬度和反射波。两组在性别、年龄、高血压或血脂异常、体重指数、收缩压和舒张压水平、总胆固醇水平和吸烟习惯方面无显著差异(>0.05)。然而,RVO 患者的 FMD 受损(=0.002),PWV 增加(=0.004),即使在调整了几个混杂因素后也是如此。FMD 和 PWV 与 RVO 的发生均显著相关,并且独立相关。此外,PWV 与收缩压之间仅存在显著正相关,仅在 CL 组中存在。因此,我们已经表明 RVO 与显著的内皮功能障碍和动脉僵硬度增加有关。我们的研究结果强化了血管理论,即全身内皮功能障碍和动脉硬化在 RVO 的发病机制中起重要作用。

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