TY - JOUR
T1 - Diastolic left ventricular function in relation to the retinal microvascular fractal dimension in a Flemish population
AU - Wei, F.F.
AU - Thijs, L.
AU - Melgarejo, J.D.
AU - Cauwenberghs, N.
AU - Zhang, Z.Y.
AU - Liu, C.
AU - Kuznetsova, T.
AU - Struijker-Boudier, H.A.J.
AU - Verhamme, P.
AU - Dong, Y.G.
AU - Staessen, J.A.
N1 - Funding Information:
Funding The European Union (HEALTH-F7-305507-HOMAGE), the European Research Council (Advanced Researcher Grant 2011-294713-EPLORE and Proof-of-Concept Grant 713601-uPROPHET), the European Research Area Net for Cardiovascular Diseases (JTC2017-046-PROACT), and the Research Foundation Flanders, Ministry of the Flemish Community, Brussels, Belgium (G.0881.13) supported the Studies Coordinating Centre in Leuven. The manuscript was also supported by the National Natural Science Foundation of China (82000372) and China Postdoctoral Science Foundation (2019M663312). The NPA Alliance for the Promotion of Preventive Medicine (APPREMED), Mechelen, Belgium received a nonbinding grant from OMRON Healthcare Co. Ltd., Kyoto, Japan.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/4
Y1 - 2021/4
N2 - Fractal analysis provides a global assessment of vascular networks (e.g., geometric complexity). We examined the association of diastolic left ventricular (LV) function with the retinal microvascular fractal dimension. A lower fractal dimension signifies a sparser retinal microvascular network. In 628 randomly recruited Flemish individuals (51.3% women; mean age, 50.8 years), we measured diastolic LV function by echocardiography and the retinal microvascular fractal dimension by the box-counting method (Singapore I Vessel Assessment software, version 3.6). The left atrial volume index (LAVI), e ', E/e ' and retinal microvascular fractal dimension averaged (+/- SD) 24.3 +/- 6.2 mL/m(2), 10.9 +/- 3.6 cm/s, 6.96 +/- 2.2, and 1.39 +/- 0.05, respectively. The LAVI, E, e ' and E/e ' were associated (P < 0.001) with the retinal microvascular fractal dimension with association sizes (per 1 SD), amounting to -1.49 mL/m(2) (95% confidence interval, -1.98 to -1.01), 2.57 cm/s (1.31-3.84), 1.34 cm/s (1.07-1.60), and -0.74 (-0.91 to -0.57), respectively. With adjustments applied for potential covariables, the associations of E peak and E/e ' with the retinal microvascular fractal dimension remained significant (P <= 0.020). Over a median follow-up of 5.3 years, 18 deaths occurred. The crude and adjusted hazard ratios expressing the risk of all-cause mortality associated with a 1-SD increment in the retinal microvascular fractal dimension were 0.36 (0.23-0.57; P < 0.001) and 0.57 (0.34-0.96; P = 0.035), respectively. In the general population, a lower retinal microvascular fractal dimension was associated with greater E/e ', a measure of LV filling pressure. These observations can potentially be translated into new strategies for the prevention of diastolic LV dysfunction.
AB - Fractal analysis provides a global assessment of vascular networks (e.g., geometric complexity). We examined the association of diastolic left ventricular (LV) function with the retinal microvascular fractal dimension. A lower fractal dimension signifies a sparser retinal microvascular network. In 628 randomly recruited Flemish individuals (51.3% women; mean age, 50.8 years), we measured diastolic LV function by echocardiography and the retinal microvascular fractal dimension by the box-counting method (Singapore I Vessel Assessment software, version 3.6). The left atrial volume index (LAVI), e ', E/e ' and retinal microvascular fractal dimension averaged (+/- SD) 24.3 +/- 6.2 mL/m(2), 10.9 +/- 3.6 cm/s, 6.96 +/- 2.2, and 1.39 +/- 0.05, respectively. The LAVI, E, e ' and E/e ' were associated (P < 0.001) with the retinal microvascular fractal dimension with association sizes (per 1 SD), amounting to -1.49 mL/m(2) (95% confidence interval, -1.98 to -1.01), 2.57 cm/s (1.31-3.84), 1.34 cm/s (1.07-1.60), and -0.74 (-0.91 to -0.57), respectively. With adjustments applied for potential covariables, the associations of E peak and E/e ' with the retinal microvascular fractal dimension remained significant (P <= 0.020). Over a median follow-up of 5.3 years, 18 deaths occurred. The crude and adjusted hazard ratios expressing the risk of all-cause mortality associated with a 1-SD increment in the retinal microvascular fractal dimension were 0.36 (0.23-0.57; P < 0.001) and 0.57 (0.34-0.96; P = 0.035), respectively. In the general population, a lower retinal microvascular fractal dimension was associated with greater E/e ', a measure of LV filling pressure. These observations can potentially be translated into new strategies for the prevention of diastolic LV dysfunction.
KW - fractal dimension
KW - left ventricular diastolic function
KW - population science
KW - retinal microcirculation
KW - Left ventricular diastolic function
KW - Population science
KW - Fractal dimension
KW - Retinal microcirculation
U2 - 10.1038/s41440-021-00623-3
DO - 10.1038/s41440-021-00623-3
M3 - Article
C2 - 33542474
SN - 0916-9636
VL - 44
SP - 446
EP - 453
JO - Hypertension Research
JF - Hypertension Research
IS - 4
ER -