Sadowski Janusz, Targonski Ryszard, Cyganski Piotr, Nowek Paulina, Starek-Stelmaszczyk Magdalena, Zajac Katarzyna, Juranek Judyta, Wojtkiewicz Joanna, Rynkiewicz Andrzej
Department of Cardiology and Internal Medicine, School of Medicine, University of Warmia and Mazury, 10-045 Olsztyn, Poland.
Department of Human Physiology and Pathophysiology, School of Medicine, University of Warmia and Masuria, 10-900 Olsztyn, Poland.
J Clin Med. 2022 Jun 27;11(13):3721. doi: 10.3390/jcm11133721.
Current data indicate that heart failure (HF) is associated with inflammation and microvascular dysfunction and remodeling. These mechanisms could be involved in HF development and progression, especially in HF with preserved ejection fraction (HFpEF). We aimed to compare structural changes in retinal arterioles and carotid arteries between HF patients and patients without heart failure. This preliminary, retrospective, case-control study included 28 participants (14 patients with HFpEF and 14 age- and sex-matched healthy controls). Carotid intima-media thickness to lumen ratio (cIMTLR) was assessed using B-mode ultrasonography. Retinal arterioles wall- to-lumen ratio (rWLR) was assessed by adaptive optics camera rtx1. The HF patients had higher IMTLR (Δ [HFpEF-control group] 0.07, = 0.01) and eWLR (Δ 0.03, = 0.001) in comparison to patients without HF. In the whole study group, rWLR correlated significantly with IMTLR (r = 0.739, = 0.001). Prevalence of arterial hypertension was similar in both groups, however, patients with HF had a significantly lower office, central and 24-h ambulatory blood pressure (systolic Δ -21 to -18 mmHg; diastolic Δ -23 to -10 mmHg). Our data suggests gradual and simultaneous progression of vascular remodeling in both retinal arterioles and carotid arteries in HFpEF patients. This process could be a marker of HF development. Significantly lower blood pressure values in HF group may indicate that vascular remodeling could be independent of BP control. Nevertheless, further and larger prospective studies allowing to reduce the impact of confounding and address temporality are warranted.
目前的数据表明，心力衰竭（HF）与炎症、微血管功能障碍及重塑有关。这些机制可能参与了HF的发生和发展，尤其是射血分数保留的心力衰竭（HFpEF）。我们旨在比较HF患者与无心力衰竭患者视网膜小动脉和颈动脉的结构变化。这项初步的回顾性病例对照研究纳入了28名参与者（14例HFpEF患者和14名年龄及性别匹配的健康对照）。使用B型超声评估颈动脉内膜中层厚度与管腔比值（cIMTLR）。通过自适应光学相机rtx1评估视网膜小动脉壁与管腔比值（rWLR）。与无HF的患者相比，HF患者的IMTLR（Δ[HFpEF-对照组]0.07，P = 0.01）和rWLR（Δ0.03，P = 0.001）更高。在整个研究组中，rWLR与IMTLR显著相关（r = 0.739，P = 0.001）。两组的动脉高血压患病率相似，然而，HF患者的诊室血压、中心血压和24小时动态血压显著更低（收缩压Δ -21至-18 mmHg；舒张压Δ -23至-10 mmHg）。我们的数据表明，HFpEF患者的视网膜小动脉和颈动脉血管重塑呈渐进性且同时发生。这一过程可能是HF发生的一个标志。HF组显著更低的血压值可能表明血管重塑可能独立于血压控制。尽管如此，仍需要进一步开展更大规模的前瞻性研究，以减少混杂因素的影响并解决时间顺序问题。
