Abstract 12413: Retinal Vascular Alterations are Accompanied by Specific Cardiac Remodeling in Essential Hypertension
Introduction: In the setting of essential hypertension, scarce data exist regarding the associations between retinal vascular alterations and cardiac remodeling process. Hypothesis: We assessed the hypothesis that there might be a link between fundus vascular changes and echocardiographically derived parameters of cardiac maladaptation.
Methods: Our study population consisted of 229 stage I-II untreated essential hypertensive subjects ( aged 62±10 years, 120 female, office blood pressure 155/92 mmHg), free of clinically evident cardiovascular disease. All participants underwent routine blood test analysis, 24 hour ambulatory blood pressure monitoring (ABPM), complete echocardiographic study and fundoscopy examination. The subjects were divided into five categories according to Scheie's fundus grading system of severity ( 0, I, II, III, IV: normal, arteriolar narrowing, arteriovenous nipping, hemorrhages-exudates and pappiloedema respectively).
Results: The five groups did not differ concerning age, sex, basic ABPM parameters, as well as their metabolic profile ( fasting glucose, serum lipids, uric acid). Deterioration of the retinal vascular category was associated with a statistically significant impairment of ejection fraction ( 63±2% vs 61±1.8% vs 60.3±2.2% vs 58.2 ±1.5% vs 56.1±2.4%, respectively, all p=0.01 ) accompanied by an increase in interventricular septum endiastolic thickness ( 9.9±0.24 vs 10±0.28 vs 10.3±0.35 vs 10.4±0.4 vs 10.7±0.45 mm, respectively, p=0.013 ) and left atrial anteroposterior diameter ( 37±0.7 vs 39.11±1.1 vs 39.26±1.2 vs 41.06±1.31 vs 42.01±1.53 mm, p=0.029 ). On the contrary, the five categories did not differ regarding left atrial volume (p=0.287), left atrial volume index ( p=0.319 ) and posterior wall endiastolic thickness ( p=0.232).
Conclusions: In essential hypertensive patients, progressive escalation of fundus vasculature damage is accompanied by commensurate left atrial and ventricular remodeling, as well as respective global impairement of left venticular systolic function. Further validation is necessary so that we can gain further insight and reveal the underlying pathophysiology.
- © 2012 by American Heart Association, Inc.