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Rebekka Heitmar, Robert P. Cubbidge, Gregory Y. H. Lip, Doina Gherghel, Andrew D. Blann; Altered Blood Vessel Responses in the Eye and Finger in Coronary Artery Disease. Invest. Ophthalmol. Vis. Sci. 2011;52(9):6199-6205. doi: 10.1167/iovs.10-6628.
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Cardiac function, such as heart rate variability, is abnormal in coronary artery disease, but its relation with the function of ocular and nail-fold blood vessels is unknown. The hypothesis was that there is abnormal retinal and peripheral microvascular endothelial function compared with large blood vessel and cardiac function. Twenty-four patients with coronary artery disease (CAD) and 30 healthy, age- and sex-matched control subjects were enrolled in the study.
Peripheral microcirculatory function was measured with continuous retinal vessel diameter assessment and nail-fold capillaroscopy. Systemic vascular function was evaluated by 24-hour blood pressure, arterial stiffness, low (LF)- and high (HF)-frequency heart rate variability, ECG monitoring, and the plasma markers von Willebrand factor (vWf) and soluble E selectin.
Peripheral nail-fold capillary (P = 0.009) and retinal vessel (average baseline corrected flicker response [BFR]; P = 0.034) responses and reaction time in response to flicker (P = 0.016) were significantly different in patients compared with controls. Furthermore, patients demonstrated higher arterial stiffness (P = 0.005), LF and HF heart rate variability (P = 0.004, P = 0.006), and vWf level (P = 0.044), but there was no difference in soluble E selectin level (P = 0.278). In the CAD patients, LF and HF heart rate variability both correlated with average BFR (r = 0.58, P = 0.004; r = −0.6, P = 0.003, respectively). There was no such relationship in the healthy controls.
Microcirculatory abnormalities of the retina and nail-fold vessels are present in CAD. The two indices of heart rate variability correlated with an index of ocular vessel responses. The latter may be a surrogate marker of abnormal heart rate variability in CAD.
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