Author + information
- Received January 25, 2007
- Revision received March 2, 2007
- Accepted March 6, 2007
- Published online July 3, 2007.
- Ning Cheung, MBBS⁎,†,
- David A. Bluemke, MD, PhD‡,
- Ronald Klein, MD, MPH§,
- A. Richey Sharrett, MD, DrPH∥,
- F.M. Amirul Islam, PhD⁎,
- Mary Frances Cotch, PhD¶,
- Barbara E.K. Klein, MD, MPH§,
- Michael H. Criqui, MD, MPH# and
- Tien Yin Wong, MD, PhD⁎,⁎⁎,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Tien Yin Wong, Centre for Eye Research Australia, University of Melbourne, 32 Gisborne Street, East Melbourne 3002, Australia.
Objectives This study sought to examine the relationships of retinal vascular signs with left ventricular (LV) mass, volume, and concentric remodeling.
Background Microvascular disease, reflected as retinopathy lesions, has been shown to predict clinical congestive heart failure. Whether these retinal vascular changes are related to early structural alterations and remodeling of the heart in asymptomatic individuals is unknown.
Methods A cross-sectional, population-based study of 4,593 participants ages 45 to 85 years, free of clinical cardiovascular disease. Retinal vascular calibers and retinopathy were graded from retinal photographs according to standardized protocols. The LV mass and volume were measured from cardiac magnetic resonance imaging. Extent of LV concentric remodeling was determined by the ratio of LV mass to end-diastolic volume (M/V ratio).
Results After controlling for age, gender, race, center, past and current systolic blood pressure, body mass index, smoking, antihypertensive medications, diabetes, diabetes duration, glycosylated hemoglobin, lipid profile, and C-reactive protein, narrower retinal arteriolar caliber was associated with concentric (highest quintile of M/V ratio) remodeling (odds ratio [OR] 2.06, 95% confidence interval 1.57 to 2.70). This association was seen in men and women, and was present even in those without diabetes, without hypertension, and without significant coronary calcification. In multivariate analysis, the presence of retinopathy (OR 1.31, 95% confidence interval 1.08 to 1.61) was also associated with concentric remodeling.
Conclusions 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.
Supported by contracts N01-HC-95159 through N01-HC-95165 and N01-HC-95169 from the National Heart, Lung, and Blood Institute. Additional support was provided by National Institutes of Health grant HL69979-03 (to Drs. Klein and Wong) and a grant from the National Heart Foundation, Victoria, Australia (to Dr. Wong). George Diamond, MD, acted as the Guest Editor for this article.
- Received January 25, 2007.
- Revision received March 2, 2007.
- Accepted March 6, 2007.
- American College of Cardiology Foundation