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The relationship between aortic stiffness and changes in retinal microvessels among Asian ischemic stroke patients.

Abstract
Large-artery stiffness is a risk factor for stroke, including cerebral small-vessel disease. Retinal microvascular changes are thought to mirror those in cerebral microvessels. We investigated the relationship between aortic stiffness and retinal microvascular changes in Asian ischemic stroke patients. We studied 145 acute ischemic stroke patients in Singapore who had aortic stiffness measurements using carotid-femoral pulse wave velocity (cPWV). Retinal photographs were assessed for retinal microvessel caliber and qualitative signs of focal arteriolar narrowing, arteriovenous nicking and enhanced arteriolar light reflex. Aortic stiffening was associated with retinal arteriolar changes. Retinal arteriolar caliber decreased with increasing cPWV (r=-0.207, P=0.014). After adjusting for age, gender, hypertension, diabetes, mean arterial pressure and small-vessel stroke subtype, patients within the highest cPWV quartile were more likely to have generalized retinal arteriolar narrowing defined as lowest caliber tertile (odds ratio (OR) 6.84, 95% confidence interval (CI) 1.45-32.30), focal arteriolar narrowing (OR 13.85, CI 1.82-105.67), arteriovenous nicking (OR 5.08, CI 1.12-23.00) and enhanced arteriolar light reflex (OR 3.83, CI 0.89-16.48), compared with those within the lowest quartile. In ischemic stroke patients, aortic stiffening is associated with retinal arteriolar luminal narrowing as well as features of retinal arteriolosclerosis.
AuthorsD A De Silva, F-P Woon, J J F Manzano, E Y Liu, H-M Chang, C Chen, J J Wang, P Mitchell, B A Kingwell, J D Cameron, R I Lindley, T Y Wong, M-C Wong, behalf of the Multi-Centre Retinal Stroke Study Collaborative Group
JournalJournal of human hypertension (J Hum Hypertens) Vol. 26 Issue 12 Pg. 716-22 (Dec 2012) ISSN: 1476-5527 [Electronic] England
PMID21975690 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Aged
  • Arteriosclerosis (epidemiology)
  • Asian People
  • Blood Pressure (physiology)
  • Carotid Arteries (physiology)
  • Cohort Studies
  • Female
  • Femoral Artery (physiology)
  • Humans
  • Male
  • Microcirculation (physiology)
  • Microvessels (physiopathology)
  • Middle Aged
  • Pulse Wave Analysis
  • Retinal Vessels (physiopathology)
  • Retrospective Studies
  • Risk Factors
  • Singapore (epidemiology)
  • Stroke (epidemiology, ethnology, physiopathology)
  • Vascular Stiffness (physiology)

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