Retinal Vascular Changes in Heart Failure with Preserved Ejection Fraction Using Optical Coherence Tomography Angiography

Jerremy Weerts*, Anne G. Raafs, Birgit Sandhoefner, Frank C. T. van der Heide, Sanne G. J. Mourmans, Nicolas Wolff, Robert P. Finger, Peyman Falahat, Maximilian W. M. Wintergerst, Vanessa P. M. van Empel, Stephane R. B. Heymans*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Systemic microvascular regression and dysfunction are considered important underlying mechanisms in heart failure with preserved ejection fraction (HFpEF), but retinal changes are unknown. Methods: This prospective study aimed to investigate whether retinal microvascular and structural parameters assessed using optical coherence tomography angiography (OCT-A) differ between patients with HFpEF and control individuals (i.e., capillary vessel density, thickness of retina layers). We also aimed to assess the associations of retinal parameters with clinical and echocardiographic parameters in HFpEF. HFpEF patients, but not controls, underwent echocardiography. Macula-centered 6 x 6 mm volume scans were computed of both eyes. Results: Twenty-two HFpEF patients and 24 controls without known HFpEF were evaluated, with an age of 74 [68-80] vs. 68 [58-77] years (p = 0.027), and 73% vs. 42% females (p = 0.034), respectively. HFpEF patients showed vascular degeneration compared to controls, depicted by lower macular vessel density (p < 0.001) and macular ganglion cell-inner plexiform layer thickness (p = 0.025), and a trend towards lower total retinal volume (p = 0.050) on OCT-A. In HFpEF, a lower total retinal volume was associated with markers of diastolic dysfunction (septal e', septal and average E/e': R-2 = 0.38, 0.36, 0.25, respectively; all p < 0.05), even after adjustment for age, sex, diabetes mellitus, or atrial fibrillation. Conclusions: Patients with HFpEF showed clear levels of retinal vascular changes compared to control individuals, and retinal alterations appeared to be associated with markers of more severe diastolic dysfunction in HFpEF. OCT-A may therefore be a promising technique for monitoring systemic microvascular regression and cardiac diastolic dysfunction.
Original languageEnglish
Article number1892
Number of pages11
JournalJournal of Clinical Medicine
Volume13
Issue number7
DOIs
Publication statusPublished - 1 Apr 2024

Keywords

  • heart failure with preserved ejection fraction
  • OCT-A
  • LV diastolic dysfunction
  • retina alterations
  • microvascular density
  • imaging biomarker
  • PERIPAPILLARY
  • DYSFUNCTION
  • AGE

Fingerprint

Dive into the research topics of 'Retinal Vascular Changes in Heart Failure with Preserved Ejection Fraction Using Optical Coherence Tomography Angiography'. Together they form a unique fingerprint.

Cite this