Reduced retinal microvascular density in women with coronary microvascular dysfunction: A pilot study
Objective: To compare retinal microvascular density among women with ischemia with no obstructive coronary artery disease (INOCA) with and without coronary microvascular dysfunction (CMD). Design: Cross-sectional study. Setting: Patients with myocardial INOCA often have CMD, possibly indicating syst...
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| Language: | English |
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Elsevier
2025-03-01
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| Series: | American Heart Journal Plus |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666602225000059 |
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| author | Sakshi Shiromani Ahmed AlBadri Aaron Lindeke-Myers Arielle Schwartz Nishant Vatsa Esha Dave Fauzia Rashid Nieraj Jain Puja K. Mehta |
| author_facet | Sakshi Shiromani Ahmed AlBadri Aaron Lindeke-Myers Arielle Schwartz Nishant Vatsa Esha Dave Fauzia Rashid Nieraj Jain Puja K. Mehta |
| author_sort | Sakshi Shiromani |
| collection | DOAJ |
| description | Objective: To compare retinal microvascular density among women with ischemia with no obstructive coronary artery disease (INOCA) with and without coronary microvascular dysfunction (CMD). Design: Cross-sectional study. Setting: Patients with myocardial INOCA often have CMD, possibly indicating systemic vascular dysfunction. While retinal microvasculature relates to many cardiovascular risk factors, its link with CMD remains unknown. Participants: Women with INOCA (N = 18) and coronary function testing were enrolled and classified into CMD and non-CMD groups, with CMD defined as coronary flow reserve (CFR) <2.5 in response to adenosine. Interventions: Participants underwent retinal optical coherence tomography angiography for noninvasive imaging of the retinal microvasculature. Main outcome measures: Vessel density, perfusion density, and area, perimeter, and circularity of the foveal avascular zone (FAZ). Non-parametric statistics were used for comparisons. Results: Mean age was 54.7 (SD 12.5) years. The CMD (N = 11) and non-CMD (N = 7) groups were balanced with respect to age, BMI, systemic diseases including diabetes, hypertension, and hyperlipidemia, and medications. Those with CMD had a lower retinal vessel density [20.9 (0.7) vs 21.6(0.8), p = 0.006] and lower inner perfusion density [38.5 (1.6) vs 41.2 (0.8), p = 0.006] as compared to those without CMD. There were no differences in the FAZ area, perimeter, or circularity. Conclusions: In this study of women with INOCA, those with CMD showed lower retinal microvascular and perfusion densities than those without CMD. Direct, non-invasive retinal imaging is feasible, affordable, and may reflect coronary microvascular function in INOCA patients. A larger study, including men, is needed to confirm these findings. |
| format | Article |
| id | doaj-art-0f27338d25674120879fe3f12e2d0551 |
| institution | Kabale University |
| issn | 2666-6022 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Heart Journal Plus |
| spelling | doaj-art-0f27338d25674120879fe3f12e2d05512025-02-05T04:32:42ZengElsevierAmerican Heart Journal Plus2666-60222025-03-0151100502Reduced retinal microvascular density in women with coronary microvascular dysfunction: A pilot studySakshi Shiromani0Ahmed AlBadri1Aaron Lindeke-Myers2Arielle Schwartz3Nishant Vatsa4Esha Dave5Fauzia Rashid6Nieraj Jain7Puja K. Mehta8Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USAInterventional Cardiology, Wellstar Health System, Marietta, GA, USADepartment of Ophthalmology, Duke University School of Medicine, Durham, NC, USACardiovascular Disease Fellowship Training Program, Emory University School of Medicine, Atlanta, GA, USACardiovascular Disease Fellowship Training Program, Emory University School of Medicine, Atlanta, GA, USAEmory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USAEmory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USADepartment of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USAEmory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA; Corresponding author at: 1750 Haygood Drive, Health Sciences Research Building II, 2nd floor, Office N243, Atlanta, GA 30322, USA.Objective: To compare retinal microvascular density among women with ischemia with no obstructive coronary artery disease (INOCA) with and without coronary microvascular dysfunction (CMD). Design: Cross-sectional study. Setting: Patients with myocardial INOCA often have CMD, possibly indicating systemic vascular dysfunction. While retinal microvasculature relates to many cardiovascular risk factors, its link with CMD remains unknown. Participants: Women with INOCA (N = 18) and coronary function testing were enrolled and classified into CMD and non-CMD groups, with CMD defined as coronary flow reserve (CFR) <2.5 in response to adenosine. Interventions: Participants underwent retinal optical coherence tomography angiography for noninvasive imaging of the retinal microvasculature. Main outcome measures: Vessel density, perfusion density, and area, perimeter, and circularity of the foveal avascular zone (FAZ). Non-parametric statistics were used for comparisons. Results: Mean age was 54.7 (SD 12.5) years. The CMD (N = 11) and non-CMD (N = 7) groups were balanced with respect to age, BMI, systemic diseases including diabetes, hypertension, and hyperlipidemia, and medications. Those with CMD had a lower retinal vessel density [20.9 (0.7) vs 21.6(0.8), p = 0.006] and lower inner perfusion density [38.5 (1.6) vs 41.2 (0.8), p = 0.006] as compared to those without CMD. There were no differences in the FAZ area, perimeter, or circularity. Conclusions: In this study of women with INOCA, those with CMD showed lower retinal microvascular and perfusion densities than those without CMD. Direct, non-invasive retinal imaging is feasible, affordable, and may reflect coronary microvascular function in INOCA patients. A larger study, including men, is needed to confirm these findings.http://www.sciencedirect.com/science/article/pii/S2666602225000059Coronary microvascular dysfunctionOptical coherence tomography angiographyRetinal microvasculatureWomenBiomarkers |
| spellingShingle | Sakshi Shiromani Ahmed AlBadri Aaron Lindeke-Myers Arielle Schwartz Nishant Vatsa Esha Dave Fauzia Rashid Nieraj Jain Puja K. Mehta Reduced retinal microvascular density in women with coronary microvascular dysfunction: A pilot study American Heart Journal Plus Coronary microvascular dysfunction Optical coherence tomography angiography Retinal microvasculature Women Biomarkers |
| title | Reduced retinal microvascular density in women with coronary microvascular dysfunction: A pilot study |
| title_full | Reduced retinal microvascular density in women with coronary microvascular dysfunction: A pilot study |
| title_fullStr | Reduced retinal microvascular density in women with coronary microvascular dysfunction: A pilot study |
| title_full_unstemmed | Reduced retinal microvascular density in women with coronary microvascular dysfunction: A pilot study |
| title_short | Reduced retinal microvascular density in women with coronary microvascular dysfunction: A pilot study |
| title_sort | reduced retinal microvascular density in women with coronary microvascular dysfunction a pilot study |
| topic | Coronary microvascular dysfunction Optical coherence tomography angiography Retinal microvasculature Women Biomarkers |
| url | http://www.sciencedirect.com/science/article/pii/S2666602225000059 |
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