Kim Dae Sung, Kim Byung Sik, Cho Heeyoon, Shin Jeong-Hun, Shin Yong Un
Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si 11923, Korea.
Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si 11923, Korea.
J Pers Med. 2022 May 20;12(5):839. doi: 10.3390/jpm12050839.
We evaluated the association between macular perfusion assessed via optical coherence tomography angiography (OCTA) and the cardiovascular risk profiles of patients with acute myocardial infarction (AMI). Patients with AMI who underwent comprehensive ophthalmological examinations and retinal OCTA were evaluated retrospectively. Retinal OCTA was performed for each patient within 3 days of admission. Quantitative analyses of the vessel density (VD) of the superficial capillary plexus (SCP) layers, deep capillary plexus layers (DCP), and choriocapillaris were performed after image processing. The 10-year risk of atherosclerotic cardiovascular disease (ASCVD), Global Registry of Acute Coronary Events (GRACE) score, reduction of atherothrombosis for continued health (REACH) score, and thrombolysis in myocardial infarction (TIMI) risk score were assessed. Sixty patients were included. VD in SCP and DCP was not associated with a 10-year ASCVD risk; however, choriocapillaris flow void features were significantly correlated with the 10-year ASCVD risk: decreased count, increased average size, and increased signal void area were correlated with increased 10-year ASCVD risk, GRACE score, REACH score, and TIMI risk score. In the multivariate analysis, a 10-year ASCVD risk (adjusted odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01-1.08) and brain natriuretic peptide (adjusted OR, 1.00; 95% CI, 1.00-1.01) were significantly associated with the highest tertile of the average size of the choriocapillaris. Choriocapillaris flow void features measured using OCTA were associated with cardiovascular risk profiles in patients with AMI. OCTA may be used as an indicator of cardiovascular risk profiles and could improve cardiovascular risk assessments.
我们评估了通过光学相干断层扫描血管造影（OCTA）评估的黄斑灌注与急性心肌梗死（AMI）患者心血管风险状况之间的关联。对接受全面眼科检查和视网膜OCTA的AMI患者进行回顾性评估。在入院3天内对每位患者进行视网膜OCTA检查。图像处理后对浅表毛细血管丛（SCP）层、深层毛细血管丛层（DCP）和脉络膜毛细血管的血管密度（VD）进行定量分析。评估动脉粥样硬化性心血管疾病（ASCVD）的10年风险、全球急性冠状动脉事件注册（GRACE）评分、持续健康动脉粥样硬化血栓形成减少（REACH）评分以及心肌梗死溶栓（TIMI）风险评分。纳入60例患者。SCP和DCP中的VD与10年ASCVD风险无关；然而，脉络膜毛细血管血流缺失特征与10年ASCVD风险显著相关：计数减少、平均大小增加和信号缺失面积增加与10年ASCVD风险、GRACE评分、REACH评分和TIMI风险评分增加相关。在多变量分析中，10年ASCVD风险（调整优势比[OR]，1.04；95%置信区间[CI]，1.01 - 1.08）和脑钠肽（调整OR，1.00；95% CI，1.00 - 1.01）与脉络膜毛细血管平均大小最高三分位数显著相关。使用OCTA测量的脉络膜毛细血管血流缺失特征与AMI患者的心血管风险状况相关。OCTA可用作心血管风险状况的指标，并可改善心血管风险评估。
