Jeyakumar, Sambavan and Nguyen, Helen and Robson, Desiree and Olsen, Nick and Schnegg, Bruno and Macdonald, Peter and Fraser, Clare L. and Liew, Gerald and Jiang, Jacky and Hayward, Christopher and Muthiah, Kavitha (2024) Retinal microvascular remodeling associates with adverse events in continuous-flow left ventricular assist device-supported patients. The Journal of Heart and Lung Transplantation, 43 (12). pp.1975-1984. ISSN 10532498
Full text not available from this repository.Abstract
BACKGROUND: Continuous-flow left ventricular assist device (cfLVAD) use is effective in supporting patients with end-stage heart failure (ESHF). Reduced flow pulsatility within the systemic circulation in cfLVAD-supported patients may lead to alterations within the microcirculation. Temporal changes in microvasculature in relation to adverse events in cfLVAD-supported patients have not been studied. We aimed to profile changes within retinal microvasculature and its association with adverse events. METHODS: Retinal photography was performed using Topcon TRC-NW8 nonmydriatic fundus camera in cfLVAD-supported patients and ESHF control patients. Specific retinal measurements were evaluated using a validated semiautomated program. Demographic and adverse event data were documented. RESULTS: Forty-eight patients were studied (n = 29 cfLVAD, n = 19 ESHF). There were significant trends in retinal arteriolar caliber (B = -0.53 microm, 95% confidence interval [CI]: -0.96 to -0.10, p = 0.016) and retinal fractal dimension parameters (B = 0.014, 95% CI: 0.001-0.002, p = 0.016) in linear mixed model regressions. Among cfLVAD patients, there was a significant association between the incidence of gastrointestinal bleeding and stepwise increases in retinal arteriolar-venular caliber ratio (hazard ratio: 3.03, 95% CI: 2.06-4.45, p = 0.005), a measure of arteriolar narrowing. CONCLUSIONS: We have observed for the first time that alterations in retinal microvasculature in cfLVAD-supported patients may be associated with gastrointestinal bleeding. While understanding these temporal changes may predict future adverse events in cfLVAD-supported patients, further multicenter studies are required to confirm the associations observed.
| Item Type: | Article |
|---|---|
| Subjects: | R Medicine > R Medicine (General) |
| Depositing User: | Repository Administrator |
| Date Deposited: | 01 Jan 2025 23:33 |
| Last Modified: | 01 Jan 2025 23:33 |
| URI: | https://eprints.victorchang.edu.au/id/eprint/1611 |
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