Retinal Arteriolar Narrowing and Left Ventricular Remodeling
Journal of the American College of CardiologyPublished 19 June 2007Open access
Ning Cheung, David A. Bluemke, Ronald Klein, A. Richey Sharrett, Amirul Islam, Mary Frances Cotch
Citations160
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Narrower retinal arteriolar caliber is associated with LV concentric remodeling independent of traditional risk factors and coronary atherosclerotic burden, supporting the hypothesis that microvascular disease may contribute to cardiac remodeling.
Abstract
Narrower retinal arteriolar caliber is associated with LV concentric remodeling independent of traditional risk factors and coronary atherosclerotic burden, supporting the hypothesis that microvascular disease may contribute to cardiac remodeling.
Keywords
Medicine
New England Journal of MedicinePrognostic Implications of Echocardiographically Determined Left Ventricular Mass in the Framingham Heart Study
5,709 Citations1990Daniel Levy, Robert J. Garrison +3 more
The estimation of left ventricular mass by echocardiography offers prognostic information beyond that provided by the evaluation of traditional cardiovascular risk factors, and it is concluded that an increase in left Ventricular mass predicts a higher incidence of clinical events, including death, attributable to cardiovascular disease.
American Journal of EpidemiologyMulti-Ethnic Study of Atherosclerosis: Objectives and Design
3,958 Citations2002Diane E. Bild
The Multi-Ethnic Study of Atherosclerosis was initiated in July 2000 to investigate the prevalence, correlates, and progression of subclinical cardiovascular disease (CVD) in a population-based sample of 6,500 men and women aged 45-84 years for identification and characterization of CVD events.
CirculationVentricular remodeling after myocardial infarction. Experimental observations and clinical implications.
2,869 Citations1990Marc A. Pfeffer, Eugene Braunwald
The extent of ventricular enlargement after infarction is related to the magnitude of the initial damage to the myocardium and, although an increase in cavity size tends to restore stroke volume despite a persistently depressed ejection fraction, ventricular dilation has been associated with a reduction in survival.
Journal of the American College of CardiologyCardiac remodeling—concepts and clinical implications: a consensus paper from an international forum on cardiac remodeling
2,574 Citations2000Jay N. Cohn, Roberto Ferrari +1 more
Left ventricular end-diastolic and end-systolic volume and ejection fraction data provide support for the beneficial effects of therapeutic agents such as angiotensin-converting enzyme (ACE) inhibitors and beta-adrenergic blocking agents on the remodeling process.
OphthalmologyGrading Diabetic Retinopathy from Stereoscopic Color Fundus Photographs—An Extension of the Modified Airlie House Classification
1,992 Citations1991
CirculationPrognostic Significance of Microvascular Obstruction by Magnetic Resonance Imaging in Patients With Acute Myocardial Infarction
1,351 Citations1998Kathérine C. Wu, Elias A. Zerhouni +6 more
After infarction, MRI-determined microvascular obstruction predicts more frequent cardiovascular complications, and infarct size determined by MRI also relates directly to long-term prognosis in patients with acute myocardial infarctions.
PubMedGrading diabetic retinopathy from stereoscopic color fundus photographs--an extension of the modified Airlie House classification. ETDRS report number 10. Early Treatment Diabetic Retinopathy Study Research Group.
1,244 Citations1991
The modified Airlie House classification of diabetic retinopathy has been extended and its reproducibility between graders is assessed by calculating percentages of agreement and kappa statistics for duplicate gradings of baseline color nonsimultaneous stereoscopic fundus photographs.
OphthalmologyMethods for evaluation of retinal microvascular abnormalities associated with hypertension/sclerosis in the atherosclerosis risk in communities study11The authors have no proprietary interest in the equipment and techniques described in this article.
1,166 Citations1999Larry D. Hubbard, Rosemary J. Brothers +7 more
Protocols have been developed for nonmydriatic fundus photography and for evaluation of retinal vascular abnormalities in the ARIC Study and several microvascular changes were significantly associated with higher blood pressure, controlling for gender, race, age, and smoking status.
CirculationClinical Implications of the ‘No Reflow’ Phenomenon
1,018 Citations1996Hiroshi Ito, Atsushi Maruyama +7 more
The substantial size of the MCE no reflow phenomenon at coronary reflow conveys useful information about an outcome of coronary intervention and left ventricular remodeling in individual patients with anterior wall AMI, although these are suggestive results in a limited number of patients.
Current Eye ResearchRevised formulas for summarizing retinal vessel diameters
850 Citations2003Michael D. Knudtson, Kristine E. Lee +4 more
Revised formulas for summarizing retinal vessel diameters measured from fundus photographs are described, which offer the advantages of being more robust against variability in the number of vessels observed, being independent of image scale, and being easier to implement.
The LancetControversies in ventricular remodelling
846 Citations2006Lionel H. Opie, Patrick Commerford +2 more
The LancetHeart failure
815 Citations2005John J.V. McMurray, Marc A. Pfeffer
There is still no firmly evidence-based treatment for heart failure with preserved ejection fraction, but there is growing evidence that left-ventricular assist devices are indicated in some patients with end-stage heart failure.
JAMARetinal Arteriolar Narrowing and Risk of Coronary Heart Disease in Men and Women
777 Citations2002Tien Yin Wong, Ronald Klein +6 more
Retinal arteriolar narrowing is related to risk of CHD in women but not in men, supporting a more prominent microvascular role in the development of CHd in women than in men.
The LancetRetinal microvascular abnormalities and incident stroke: the Atherosclerosis Risk in Communities Study
760 Citations2001Tien Yin Wong, Ronald Klein +6 more
Most retinal microvascular characteristics were predictive of incident stroke, and the associations were similar for ischaemic strokes specifically, and for strokes in individuals with hypertension, either with or without diabetes.
New England Journal of MedicineCoronary Microvascular Dysfunction and Prognosis in Hypertrophic Cardiomyopathy
758 Citations2003Franco Cecchi, Iacopo Olivotto +4 more
In patients with hypertrophic cardiomyopathy, the degree of microvascular dysfunction is a strong, independent predictor of clinical deterioration and death.
Advances in experimental medicine and biologyVentricular Remodeling after Myocardial Infarction
758 Citations1993Gary F. Mitchell, Gervasio A. Lamas +1 more
Late ventricular enlargement after anterior myocardial infarction results from an increase in contractile segment length and a change in ventricular geometry and is not a result of progressive infarct expansion.
American Journal of OphthalmologyDiabetic Retinopathy in a Multi-ethnic Cohort in the United States
694 Citations2006Tien Yin Wong, Ronald Klein +6 more
This study provides contemporary data on the prevalence of and risk factors for diabetic retinopathy among whites, blacks, hispanics, and chinese participating in the MESA.
Survey of OphthalmologyRetinal Microvascular Abnormalities and their Relationship with Hypertension, Cardiovascular Disease, and Mortality
614 Citations2001Tien Yin Wong, Ronald Klein +4 more
There is no convincing evidence of an independent or direct association with atherosclerosis, ischemic heart disease, or cardiovascular mortality, but when reliably quantified, retinal microvascular abnormalities may be useful as risk indicators for cerebrovascular diseases.
Investigative Ophthalmology & Visual ScienceRetinal Vascular Caliber, Cardiovascular Risk Factors, and Inflammation: The Multi-Ethnic Study of Atherosclerosis (MESA)
605 Citations2006Tien Yin Wong, Amirul Islam +6 more
Retinal arteriolar and venular caliber is associated with a range of cardiovascular risk factors, including hypertension, diabetes, measures of obesity, and dyslipidemia and is also associated with systemic inflammation.
CirculationEffects of the angiotensin converting enzyme inhibitor enalapril on the long-term progression of left ventricular dysfunction in patients with heart failure. SOLVD Investigators.
600 Citations1992Marvin A. Konstam, Michel F. Rousseau +8 more
In patients with heart failure and reduced LVEF, chronic ACE inhibition with enalapril prevents progressive LV dilatation and systolic dysfunction (increased ESV), which probably result from a combination of altered remodeling and sustained reduction in preload and afterload.
CirculationLeft Ventricular Remodeling After Primary Coronary Angioplasty
595 Citations2002Leonardo Bolognese, Aleksandar Nešković +5 more
LV remodeling after successful PTCA occurs despite sustained patency of the infarct-related artery and preservation of regional and global LV function, and the specific pattern of LV dilation is clearly associated with worse long-term clinical outcome.
CirculationEffects of Long-term Enalapril Therapy on Cardiac Structure and Function in Patients With Left Ventricular Dysfunction
473 Citations1995Barry Greenberg, Miguel A. Quiñones +5 more
These data demonstrate that enalapril attenuates progressive increases in LV dilatation and hypertrophy in patients with LV dysfunction and support the possibility that the favorable effects of en alapril reported in the SOLVD trials were related to inhibition of LV remodeling.
American Journal of RoentgenologyCardiovascular Function in Multi-Ethnic Study of Atherosclerosis: Normal Values by Age, Sex, and Ethnicity
456 Citations2006Shunsuke Natori, Shenghan Lai +9 more
The normal LV differs in volume and mass between sexes and among certain ethnic groups, and studies that assess cardiovascular risk factors in relationship to cardiac function and structure need to account for these normal variations in the population.
OphthalmologyComputer-assisted measurement of retinal vessel diameters in the Beaver Dam Eye Study*1methodology, correlation between eyes, and effect of refractive errors
446 Citations2004Tien Yin Wong
The data suggest that measurement of retinal vessel diameters from one eye without regard to its refractive status may provide adequate information indicative of a person's retinal vessels caliber if information from two eyes and refraction is unavailable.
CirculationMaximal Coronary Flow Reserve and Metabolic Coronary Vasodilation in Patients With Diabetes Mellitus
426 Citations1995Philip J. Nahser, Ronald E. Brown +3 more
This study demonstrates both reduced maximal coronary vasodilation and impairment in the regulation of coronary flow in response to submaximal increases in myocardial demand in patients with diabetes mellitus.
CirculationImpact of Microvascular Dysfunction on Left Ventricular Remodeling and Long-Term Clinical Outcome After Primary Coronary Angioplasty for Acute Myocardial Infarction
423 Citations2004Leonardo Bolognese, Nazario Carrabba +5 more
In reperfused acute myocardial infarction, MD within the risk area is an important predictor of both LV remodeling and unfavorable long-term outcome.
Journal of the American College of CardiologyLeft Ventricular Remodeling With Carvedilol in Patients With Congestive Heart Failure Due to Ischemic Heart Disease fn1fn1This study was funded by a grant from SmithKline Beecham; however, the study was initiated, conducted, analyzed and reported by the Australia–New Zealand Heart Failure Research Collaborative Group independently of the sponsor. The Clinical Trials Research Unit is supported by a programme grant from the Health Research Council of New Zealand.
420 Citations1997Robert N. Doughty, Gillian Whalley +3 more
In patients with heart failure due to ischemic heart disease, carvedilol therapy for 12 months reduced left ventricular volumes, increasedleft ventricular ejection fraction and prevented progressive left vent cardiac dilation, demonstrating a beneficial effect of carvedILol on left Ventricular remodeling in heart failure.
Journal of the American College of CardiologyAdverse prognostic significance of concentric remodeling of the left ventricle in hypertensive patients with normal left ventricular mass
413 Citations1995Paolo Verdecchia, Giuseppe Schillaci +8 more
Concentric remodeling of the left ventricle, defined by the thickness of the septum or posterior wall divided by theleft ventricular radius at end-diastole > or = 0.45, is an important and independent predictor of increased cardiovascular risk in hypertensive patients with normal left ventricular mass on echocardiography.
OphthalmologyPrevalence of Age-Related Macular Degeneration in 4 Racial/Ethnic Groups in the Multi-ethnic Study of Atherosclerosis
394 Citations2006Ronald Klein, Ronald Klein +7 more
Low prevalences of AMD were found in the MESA cohort in all groups, and a lower prevalence was found in blacks compared with whites, while the higher prevalence of exudative AMD in Chinese needs further study.
RadiologyCoronary Calcium Measurements: Effect of CT Scanner Type and Calcium Measure on Rescan Reproducibility—MESA Study
293 Citations2005Robert Detrano, Melissa Anderson +5 more
Electron-beam and multi-detector row CT scanners have equivalent reproducibility for measuring coronary artery calcium, and Calcium volumes and interpolated volume scores are slightly more reproducible than Agatston scores.
Journal of the American College of CardiologyAntiremodeling effects on the left ventricle during beta-blockade with metoprolol in the treatment of chronic heart failure
288 Citations2000Bjoern A. Groenning, Jens Christian Nilsson +4 more
This study is the first randomized study to demonstrate that the beta1-blocker metoprolol CR/XL has antiremodeling effects on the LV in patients with chronic heart failure and consequently provides an explanation for the highly significant decrease in mortality from worsening heart failure found in the MERIT-HF trial.
CirculationMicrovascular Obstruction and Left Ventricular Remodeling Early After Acute Myocardial Infarction
284 Citations2000Bernhard Gerber, Carlos Eduardo Rochitte +6 more
In the early healing phase of acute myocardial infarction, the extent of MO in infarcted tissue relates to reduced localMyocardial deformation and dysfunction of noninfarcte adjacent myocardium.
BMJProspective cohort study of retinal vessel diameters and risk of hypertension
255 Citations2004Tien Yin Wong, Anoop Shankar +3 more
Narrowed retinal arterioles are associated with long term risk of hypertension, suggesting that structural alterations of the microvasculature may be linked to the development of hypertension.
Archives of OphthalmologyRetinal Arteriolar Narrowing and Risk of Diabetes Mellitus in Middle-aged Persons
248 Citations2003Neil M. Bressler
Retinal arteriolar narrowing is independently associated with risk of diabetes, supporting a microvascular role in the development of clinical diabetes.
Journal of the American College of CardiologyRelevance of Coronary Microvascular Flow Impairment to Long-Term Remodeling and Systolic Dysfunction in Hypertrophic Cardiomyopathy
243 Citations2006Iacopo Olivotto, Franco Cecchi +6 more
Severe microvascular dysfunction is a potent long-term predictor of adverse LV remodeling and systolic dysfunction in HCM and is a potential target for prevention of disease progression and heart failure in H CM.
JAMARetinopathy and Risk of Congestive Heart Failure
224 Citations2005Tien Yin Wong
Retinopathy is an independent predictor of CHF, even in persons without preexisting coronary heart disease, diabetes, or hypertension, which suggests that microvascular disease may play an important role in the development of heart failure in the general population.
The LancetRole of MRI in clinical cardiology
214 Citations2004Godwin Constantine, Kesavan Shan +2 more
CMRI has been extensively studied against other established non-invasive imaging modalities and has been shown to be superior in many scenarios, particularly with respect to assessment of cardiac and great vessel morphology and left ventricular function.
British Medical BulletinHypertensive retinopathy signs as risk indicators of cardiovascular morbidity and mortality
199 Citations2005Tien Yin Wong, Rachel McIntosh
Data support the concept that an assessment of retinal vascular changes may provide further information for vascular risk stratification in persons with hypertension, and show that hypertensive retinopathy signs are strongly associated with blood pressure, but inconsistently associated with cholesterol and other risk factors of atherosclerosis.
Ophthalmic and Physiological OpticsSystemic associations of retinal microvascular signs: a review of recent population‐based studies
130 Citations2005Tien Yin Wong, Rachel McIntosh
Patients with some retinopathy signs (retinal haemorrhages, microaneurysms and cotton wool spots) may benefit from a careful systemic evaluation and, if supported by further research, appropriate risk reduction therapy.
The LancetCoronary calcification score: the coronary-risk impact factor
82 Citations2004GR Thompson, Judith Partridge
The coronary calcification score predicted total mortality within subsets of patients classified at low, intermediate, or high risk according to Framingham criteria and in a cohort of over 10000 individuals, 5-year risk-adjusted survival was 95% when the score was over 1000 compared with 99% for scores of 10 or less.
American Journal of OphthalmologyDoes refractive error influence the association of blood pressure and retinal vessel diameters? the blue mountains eye study
81 Citations2004Tien Yin Wong, Jie Jin Wang +3 more
Journal of the American College of CardiologyThe impact of diabetic retinopathy on long-term outcome following coronary artery bypass graft surgery
53 Citations2002Takayuki Ono, Junjiro Kobayashi +7 more
Diabetics with retinopathy had a distinct post-CABG course with a worse long-term prognosis, as compared with diabetics without Retina evaluation, and repeat revascularization was a strong independent predictor of overall mortality.
American Journal of OphthalmologyEffect of Axial Length on Retinal Vascular Network Geometry
51 Citations2005Niall Patton, Rishma Maini +4 more
Future studies exploring the influence of systemic disease on retinal vascular topography do not need to consider axial length as a potential confounding variable when utilizing measures such as AVR or vessel junctions, and vascular arteriolar junctional exponents may serve as a good measure of overall alteredretinal vascular geometry in cardiovascular disease.
HypertensionAre Narrower or Wider Retinal Venules Associated With Incident Hypertension?
51 Citations2006Gerald Liew, Tien Yin Wong +2 more
It is reported recently that both retinal arteriolar and venular narrowing predict incident hypertension, and this work sought to replicate these findings in the Blue Box study.
The Annals of Thoracic SurgeryImpact of Diabetic Retinopathy on Cardiac Outcome After Coronary Artery Bypass Graft Surgery: Prospective Observational Study
17 Citations2006Takayuki Ono, Takeki Ohashi +5 more
After CABG, diabetics with retinopathy have a substantially increased risk of cardiac events, especially of congestive heart failure.