TY - JOUR
T1 - Relationship between retinal arteriolar narrowing and myocardial perfusion
T2 - Multi-ethnic study of atherosclerosis
AU - Wang, Lu
AU - Wong, Tien Y.
AU - Sharrett, A. Richey
AU - Klein, Ronald
AU - Folsom, Aaron R.
AU - Jerosch-Herold, Michael
PY - 2008/1
Y1 - 2008/1
N2 - Retinal arteriolar narrowing is a marker of chronic hypertension. Myocardial perfusion reflects microvascular processes in the heart. The relationship between these 2 measures has not been studied previously and is examined in 212 men and women aged 45 to 84 years and free of cardiovascular disease diagnoses. Retinal caliber was measured through fundus photography and presented as central retinal arteriolar and venular caliber equivalents. Myocardial blood flow was measured using MRI during rest and adenosine-induced hyperemia. Among subjects with no coronary artery calcification (n=98), smaller retinal arteriolar caliber was associated with lower hyperemic myocardial blood flow and perfusion reserve (calculated as the ratio of hyperemic:resting blood flow). Mean hyperemic blood flow (3.43, 3.28, 3.26, and 3.09 mL/min per gram; Plinear=0.006) and mean perfusion reserve (3.52, 3.37, 3.19, and 3.10; Plinear=0.01) progressively decreased across decreasing quartiles of retinal arteriolar caliber. These associations remained significant after adjusting for age, gender, and race/ethnicity but were no longer significant after additionally adjusting for other cardiovascular risk factors. In contrast, among subjects with coronary calcification (n=114), retinal arteriolar caliber was not associated with hyperemic myocardial blood flow (Plinear=0.73) or perfusion reserve (Plinear=0.79). There were no associations between retinal venular caliber and perfusion measurements. We conclude that narrower retinal arterioles were associated with lower hyperemic myocardial blood flow and perfusion reserve in asymptomatic adults with no coronary calcification, which is partially mediated by traditional cardiovascular risk factors. This finding suggests that retinal arteriolar narrowing may serve as a marker of coronary microvascular disease.
AB - Retinal arteriolar narrowing is a marker of chronic hypertension. Myocardial perfusion reflects microvascular processes in the heart. The relationship between these 2 measures has not been studied previously and is examined in 212 men and women aged 45 to 84 years and free of cardiovascular disease diagnoses. Retinal caliber was measured through fundus photography and presented as central retinal arteriolar and venular caliber equivalents. Myocardial blood flow was measured using MRI during rest and adenosine-induced hyperemia. Among subjects with no coronary artery calcification (n=98), smaller retinal arteriolar caliber was associated with lower hyperemic myocardial blood flow and perfusion reserve (calculated as the ratio of hyperemic:resting blood flow). Mean hyperemic blood flow (3.43, 3.28, 3.26, and 3.09 mL/min per gram; Plinear=0.006) and mean perfusion reserve (3.52, 3.37, 3.19, and 3.10; Plinear=0.01) progressively decreased across decreasing quartiles of retinal arteriolar caliber. These associations remained significant after adjusting for age, gender, and race/ethnicity but were no longer significant after additionally adjusting for other cardiovascular risk factors. In contrast, among subjects with coronary calcification (n=114), retinal arteriolar caliber was not associated with hyperemic myocardial blood flow (Plinear=0.73) or perfusion reserve (Plinear=0.79). There were no associations between retinal venular caliber and perfusion measurements. We conclude that narrower retinal arterioles were associated with lower hyperemic myocardial blood flow and perfusion reserve in asymptomatic adults with no coronary calcification, which is partially mediated by traditional cardiovascular risk factors. This finding suggests that retinal arteriolar narrowing may serve as a marker of coronary microvascular disease.
KW - Coronary artery calcification
KW - Microvascular disease
KW - Myocardial perfusion
KW - Population study
KW - Retinal arteriolar narrowing
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U2 - 10.1161/HYPERTENSIONAHA.107.098343
DO - 10.1161/HYPERTENSIONAHA.107.098343
M3 - Article
C2 - 17998474
AN - SCOPUS:37349043941
SN - 0194-911X
VL - 51
SP - 119
EP - 126
JO - Hypertension
JF - Hypertension
IS - 1
ER -