Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland.
Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland.
Microvasc Res. 2022 Jul;142:104345. doi: 10.1016/j.mvr.2022.104345. Epub 2022 Feb 16.
Endothelial dysfunction represents a diagnostic marker to differentiate disease severity in chronic heart failure (CHF) patients. Retinal vessel phenotyping was applied in CHF patients as it has been acknowledged as a sensitive diagnostic tool to quantify microvascular health and overall cardiovascular risk.
The central retinal arteriolar (CRAE) and venular diameter equivalents (CRVE) as well as the retinal microvascular function, quantified by arteriolar (aFID) and venular flicker-light induced dilatation (vFID), were analyzed in 26 CHF patients. These data were compared with 26 age- and sex-matched healthy peers. The effects of an exercise intervention on retinal microvascular health in one CHF patient were investigated to demonstrate potentially beneficial effects of exercise treatment in a case report format as proof of concept.
CHF patients showed narrower CRAE (170 ± 16 μm vs. 176 ± 16 μm, p = 0.237) and wider CRVE (217 ± 20 μm vs. 210 ± 17 μm, p = 0.152), resulting in a significantly lower arteriolar-to-venular diameter ratio (AVR, 0.79 ± 0.07 vs. 0.84 ± 0.06, p = 0.004) compared to controls. More strikingly, CHF patients showed significantly lower mean aFID (1.24 ± 1.14% vs. 3.78 ± 1.85%, p < 0.001) and vFID (2.89 ± 1.33% vs. 3.88 ± 1.83%, p = 0.033). Twelve weeks of exercise therapy induced wider CRAE (143 ± 1.0 μm vs. 153 ± 0.9 μm), narrower CRVE (183 ± 3.1 μm vs. 180 ± 2.4 μm) and improved aFID (0.67% vs. 1.25%) in a male 78 years old CHF patient.
aFID is a sensitive diagnostic tool to quantify microvascular impairments in CHF patients. Exercise treatment in CHF patients has high potential to improve retinal microvascular health as a marker for vascular regeneration and overall risk reduction, which warrants further examination by randomized controlled trials.
内皮功能障碍是区分慢性心力衰竭 (CHF) 患者疾病严重程度的诊断标志物。视网膜血管表型已应用于 CHF 患者，因为它已被公认为量化微血管健康和整体心血管风险的敏感诊断工具。
在 26 名 CHF 患者中分析了中央视网膜小动脉 (CRAE) 和小静脉直径等效物 (CRVE) 以及视网膜微血管功能，通过小动脉 (aFID) 和小静脉闪烁光诱导的扩张 (vFID) 进行量化。这些数据与 26 名年龄和性别匹配的健康同龄人进行了比较。对一名 CHF 患者的视网膜微血管健康进行了运动干预效果的研究，以病例报告的形式证明运动治疗的潜在益处，作为概念验证。
CHF 患者的 CRAE（170±16μm 比 176±16μm，p=0.237）较窄，CRVE（217±20μm 比 210±17μm，p=0.152）较宽，导致小动脉与小静脉直径比（AVR，0.79±0.07 比 0.84±0.06，p=0.004）明显低于对照组。更引人注目的是，CHF 患者的平均 aFID（1.24±1.14% 比 3.78±1.85%，p<0.001）和 vFID（2.89±1.33% 比 3.88±1.83%，p=0.033）明显较低。12 周的运动治疗可使 78 岁男性 CHF 患者的 CRAE（143±1.0μm 比 153±0.9μm）变宽，CRVE（183±3.1μm 比 180±2.4μm）变窄，aFID（0.67% 比 1.25%）改善。
aFID 是量化 CHF 患者微血管损伤的敏感诊断工具。CHF 患者的运动治疗具有改善视网膜微血管健康的巨大潜力，可作为血管再生和整体风险降低的标志物，值得进一步通过随机对照试验进行检查。
