Myocardial Blood Flow and the Retinal Microvasculature Across the Spectrum From Normal to Failing Hearts

ABSTRACT Deficiency of the myocardial microcirculation plays a role in the pathogenesis of heart failure (HF). We aimed to investigate the association of myocardial blood flow (MBF) and the retinal microvasculature with left ventricular (LV) function and its potential mediators. In healthy controls...

Full description

Saved in:
Bibliographic Details
Main Authors: Jia Liu, Chang Chen, Zhongping Yu, Xuwei Chen, Zihao Chen, Wei Li, Min Ye, Xin He, Jiangui He, Juping Liu, Yugang Dong, Jan A. Staessen, Chen Liu, Fengjuan Yao, Fang‐Fei Wei
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:The Journal of Clinical Hypertension
Subjects:
Online Access:https://doi.org/10.1111/jch.70087
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849411540139114496
author Jia Liu
Chang Chen
Zhongping Yu
Xuwei Chen
Zihao Chen
Wei Li
Min Ye
Xin He
Jiangui He
Juping Liu
Yugang Dong
Jan A. Staessen
Chen Liu
Fengjuan Yao
Fang‐Fei Wei
author_facet Jia Liu
Chang Chen
Zhongping Yu
Xuwei Chen
Zihao Chen
Wei Li
Min Ye
Xin He
Jiangui He
Juping Liu
Yugang Dong
Jan A. Staessen
Chen Liu
Fengjuan Yao
Fang‐Fei Wei
author_sort Jia Liu
collection DOAJ
description ABSTRACT Deficiency of the myocardial microcirculation plays a role in the pathogenesis of heart failure (HF). We aimed to investigate the association of myocardial blood flow (MBF) and the retinal microvasculature with left ventricular (LV) function and its potential mediators. In healthy controls (HCs; n = 48), patients with cardiovascular risk factors (CVRF; n = 49) and patients with compensated HF (CHF; n = 52), we assessed LV diastolic filling pressure (E/e′), LV ejection fraction (LVEF), and global longitudinal strain (GLS) associated with MBF and the retinal arteriole‐to‐venule ratio (AVR), using multivariable regression models, while considering their direct contributions to LV function and the indirect contributions running via NT‐proBNP. Compared with HC, CHF had lower MBF and smaller AVR (p ≤ 0.002). In all participants, smaller AVR was associated with higher E/e′, lower LVEF, and lower GLS (p ≤ 0.010). Per 1 dB × dB/s MBF reduction, E/e′ increased by 0.09, whereas LVEF and GLS decreased by 0.46% and 0.14%, respectively (p < 0.001). The indirect contributions running via NT‐proBNP were all significant (p < 0.001) for MBF and for AVR related to GLS (p = 0.044) with mediation proportions of ≥29%. Across subgroups, these associations were directionally similar but lost significance given the lower sample size. Furthermore, across the spectrum of LV function, estimates of the associations of MBF with E/e′ and AVR with GLS showed a decreasing versus increasing trend (p ≤ 0.034). MBF and retinal microvasculature were associated with LV function and counterbalance the impaired LV function in CHF. NT‐proBNP, the natural vasodilating and natriuretic hormone, contributes close to 30% of the maintenance of LV function.
format Article
id doaj-art-cbe8b064090b41c5b3219f062dd74bdf
institution Kabale University
issn 1524-6175
1751-7176
language English
publishDate 2025-06-01
publisher Wiley
record_format Article
series The Journal of Clinical Hypertension
spelling doaj-art-cbe8b064090b41c5b3219f062dd74bdf2025-08-20T03:34:44ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762025-06-01276n/an/a10.1111/jch.70087Myocardial Blood Flow and the Retinal Microvasculature Across the Spectrum From Normal to Failing HeartsJia Liu0Chang Chen1Zhongping Yu2Xuwei Chen3Zihao Chen4Wei Li5Min Ye6Xin He7Jiangui He8Juping Liu9Yugang Dong10Jan A. Staessen11Chen Liu12Fengjuan Yao13Fang‐Fei Wei14Department of Cardiology The First Affiliated Hospital of Sun Yat‐Sen University Guangzhou Guangdong ChinaDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐Sen University Guangzhou Guangdong ChinaDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐Sen University Guangzhou Guangdong ChinaDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐Sen University Guangzhou Guangdong ChinaDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐Sen University Guangzhou Guangdong ChinaDepartment of Medical Ultrasonics Institute for Diagnostic and Interventional Ultrasound The First Affiliated Hospital of Sun Yat‐sen University Guangzhou Guangdong ChinaDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐Sen University Guangzhou Guangdong ChinaDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐Sen University Guangzhou Guangdong ChinaDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐Sen University Guangzhou Guangdong ChinaTianjin Key Laboratory of Retinal Functions and Diseases Tianjin Branch of National Clinical Research Center for Ocular Disease Eye Institute and School of Optometry Tianjin Medical University Eye Hospital Tianjin ChinaDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐Sen University Guangzhou Guangdong ChinaNon‐Profit Research Institute Alliance for the Promotion of Preventive Medicine Mechelen BelgiumDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐Sen University Guangzhou Guangdong ChinaDepartment of Medical Ultrasonics Institute for Diagnostic and Interventional Ultrasound The First Affiliated Hospital of Sun Yat‐sen University Guangzhou Guangdong ChinaDepartment of Cardiology The First Affiliated Hospital of Sun Yat‐Sen University Guangzhou Guangdong ChinaABSTRACT Deficiency of the myocardial microcirculation plays a role in the pathogenesis of heart failure (HF). We aimed to investigate the association of myocardial blood flow (MBF) and the retinal microvasculature with left ventricular (LV) function and its potential mediators. In healthy controls (HCs; n = 48), patients with cardiovascular risk factors (CVRF; n = 49) and patients with compensated HF (CHF; n = 52), we assessed LV diastolic filling pressure (E/e′), LV ejection fraction (LVEF), and global longitudinal strain (GLS) associated with MBF and the retinal arteriole‐to‐venule ratio (AVR), using multivariable regression models, while considering their direct contributions to LV function and the indirect contributions running via NT‐proBNP. Compared with HC, CHF had lower MBF and smaller AVR (p ≤ 0.002). In all participants, smaller AVR was associated with higher E/e′, lower LVEF, and lower GLS (p ≤ 0.010). Per 1 dB × dB/s MBF reduction, E/e′ increased by 0.09, whereas LVEF and GLS decreased by 0.46% and 0.14%, respectively (p < 0.001). The indirect contributions running via NT‐proBNP were all significant (p < 0.001) for MBF and for AVR related to GLS (p = 0.044) with mediation proportions of ≥29%. Across subgroups, these associations were directionally similar but lost significance given the lower sample size. Furthermore, across the spectrum of LV function, estimates of the associations of MBF with E/e′ and AVR with GLS showed a decreasing versus increasing trend (p ≤ 0.034). MBF and retinal microvasculature were associated with LV function and counterbalance the impaired LV function in CHF. NT‐proBNP, the natural vasodilating and natriuretic hormone, contributes close to 30% of the maintenance of LV function.https://doi.org/10.1111/jch.70087echocardiographyheart failuremyocardial blood flowretinal microvasculature
spellingShingle Jia Liu
Chang Chen
Zhongping Yu
Xuwei Chen
Zihao Chen
Wei Li
Min Ye
Xin He
Jiangui He
Juping Liu
Yugang Dong
Jan A. Staessen
Chen Liu
Fengjuan Yao
Fang‐Fei Wei
Myocardial Blood Flow and the Retinal Microvasculature Across the Spectrum From Normal to Failing Hearts
The Journal of Clinical Hypertension
echocardiography
heart failure
myocardial blood flow
retinal microvasculature
title Myocardial Blood Flow and the Retinal Microvasculature Across the Spectrum From Normal to Failing Hearts
title_full Myocardial Blood Flow and the Retinal Microvasculature Across the Spectrum From Normal to Failing Hearts
title_fullStr Myocardial Blood Flow and the Retinal Microvasculature Across the Spectrum From Normal to Failing Hearts
title_full_unstemmed Myocardial Blood Flow and the Retinal Microvasculature Across the Spectrum From Normal to Failing Hearts
title_short Myocardial Blood Flow and the Retinal Microvasculature Across the Spectrum From Normal to Failing Hearts
title_sort myocardial blood flow and the retinal microvasculature across the spectrum from normal to failing hearts
topic echocardiography
heart failure
myocardial blood flow
retinal microvasculature
url https://doi.org/10.1111/jch.70087
work_keys_str_mv AT jialiu myocardialbloodflowandtheretinalmicrovasculatureacrossthespectrumfromnormaltofailinghearts
AT changchen myocardialbloodflowandtheretinalmicrovasculatureacrossthespectrumfromnormaltofailinghearts
AT zhongpingyu myocardialbloodflowandtheretinalmicrovasculatureacrossthespectrumfromnormaltofailinghearts
AT xuweichen myocardialbloodflowandtheretinalmicrovasculatureacrossthespectrumfromnormaltofailinghearts
AT zihaochen myocardialbloodflowandtheretinalmicrovasculatureacrossthespectrumfromnormaltofailinghearts
AT weili myocardialbloodflowandtheretinalmicrovasculatureacrossthespectrumfromnormaltofailinghearts
AT minye myocardialbloodflowandtheretinalmicrovasculatureacrossthespectrumfromnormaltofailinghearts
AT xinhe myocardialbloodflowandtheretinalmicrovasculatureacrossthespectrumfromnormaltofailinghearts
AT jianguihe myocardialbloodflowandtheretinalmicrovasculatureacrossthespectrumfromnormaltofailinghearts
AT jupingliu myocardialbloodflowandtheretinalmicrovasculatureacrossthespectrumfromnormaltofailinghearts
AT yugangdong myocardialbloodflowandtheretinalmicrovasculatureacrossthespectrumfromnormaltofailinghearts
AT janastaessen myocardialbloodflowandtheretinalmicrovasculatureacrossthespectrumfromnormaltofailinghearts
AT chenliu myocardialbloodflowandtheretinalmicrovasculatureacrossthespectrumfromnormaltofailinghearts
AT fengjuanyao myocardialbloodflowandtheretinalmicrovasculatureacrossthespectrumfromnormaltofailinghearts
AT fangfeiwei myocardialbloodflowandtheretinalmicrovasculatureacrossthespectrumfromnormaltofailinghearts