25 EUROTIMES | Volume 17 | Issue 10 P atients with retinopathy are at a higher risk of developing left ventricular dysfunction than individuals without retinopathy, said Iris Walraven from the Department of Ophthalmology, VU University Medical Center, Amsterdam, the Netherlands. An analysis of 183 participants from the Hoorn study in the Netherlands showed that those who were present with retinopathy in the year 2000 had a 6.0 per cent lower left ventricular ejection fraction and an 8.3 per cent higher ventricular mass index than patients without retinopathy at baseline, when reviewed eight years later, Ms Walraven told the 22nd Meeting of the European Association for the Study of Diabetes’ Eye Complications Study Group. “In the general population of the Netherlands, the presence of retinopathy was prospectively associated with a 6.0 per cent decrease in left ventricular ejection fraction, independent of diabetes status and traditional risk factors,” Ms Walraven said. She noted that the Hoorn study is a population-based cohort study initiated in 1989 that was designed to determine the prevalence of Type 2 diabetes and its associated risk factors. In this part of the study, the Hoorn study investigators determined the presence of retinopathy by retinal photography using the EuroDiab classification system. Ms Walraven noted that heart failure often develops progressively, with a preceding (asymptomatic) period of left ventricular systolic or diastolic dysfunction. Patients with heart failure have a median survival time of only 2.1 years and there is no cure for the condition. However, lifestyle and drug interventions have shown to be effective in preventing or delaying the onset of heart failure in individuals at risk. She noted that left ventricular dysfunction can be divided into systolic dysfunction, which implies impaired pump function of the left ventricle, and diastolic dysfunction, which implies inadequate filling of the left ventricle. To investigate associations of retinopathy with changes in left ventricular systolic and diastolic function, the researchers performed echocardiography and carried out a linear regression analysis adjusting the results for age and gender and traditional risk factors for heart failure. “The pathogenesis of heart failure is still unclear. It is known that a person who smokes, who is overweight, has hypertension and/or has diabetes is at an increased risk of developing heart failure. However, these traditional risk factors do not explain the complete risk and even in the absence of these risk factors there still can remain a significant risk of developing heart failure,” Ms Walraven said. One theory that has gained some support in recent years is that there is a link between microvascular dysfunction and coronary dysfunction. The idea is that microvascular dysfunction reflects a low- grade inflammatory state of the body, which is itself a risk factor for the development of heart failure. Furthermore, recent research has shown that microaneurysms, a frequent feature in eyes with retinopathy, are also found in post-mortem hearts that suffered from heart failure. “The next question is, should we screen everyone who has retinopathy for left ventricular dysfunction? I would be careful how I answered that question and say that the next step is to validate this study in a larger study population,” Ms Walraven added. RETINOPATHY Retinopathy as a sign of future heart failure by Roibeard O’hEineachain in Dublin Iris Walraven – [email protected] contact Update RETINA Should we screen everyone who has retinopathy for leﬅ ventricular dysfunction? I would be careful how I answered that question...” “ Iris Walraven Don’t Miss Research update, see page 33

RETINOPATHY - ESCRS€¦ · no cure for the condition. However, lifestyle and drug interventions have shown to be effective in preventing or delaying the onset of heart failure in

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Page 1: RETINOPATHY - ESCRS€¦ · no cure for the condition. However, lifestyle and drug interventions have shown to be effective in preventing or delaying the onset of heart failure in

EUROTIMES | Volume 17 | Issue 10

Patients with retinopathy are at a higher risk of developing left ventricular dysfunction than individuals without retinopathy,

said Iris Walraven from the Department of Ophthalmology, VU University Medical Center, Amsterdam, the Netherlands.

An analysis of 183 participants from the Hoorn study in the Netherlands showed that those who were present with retinopathy in the year 2000 had a 6.0 per cent lower left ventricular ejection fraction and an 8.3 per cent higher ventricular mass index than patients without retinopathy at baseline, when reviewed eight years later, Ms Walraven told the 22nd Meeting of the European Association for the Study of Diabetes’ Eye Complications Study Group.

“In the general population of the Netherlands, the presence of retinopathy was prospectively associated with a 6.0 per cent decrease in left ventricular ejection fraction, independent of diabetes status and traditional risk factors,” Ms Walraven said.

She noted that the Hoorn study is a population-based cohort study initiated in 1989 that was designed to determine the prevalence of Type 2 diabetes and its associated risk factors. In this part of the study, the Hoorn study investigators determined the presence of retinopathy by retinal photography using the EuroDiab classification system.

Ms Walraven noted that heart failure often develops progressively, with a preceding (asymptomatic) period of left ventricular systolic or diastolic dysfunction. Patients with heart failure have a median survival time of only 2.1 years and there is no cure for the condition.

However, lifestyle and drug interventions have shown to be effective in preventing or delaying the onset of heart failure in individuals at risk. She noted that left ventricular dysfunction can be divided into systolic dysfunction, which implies impaired pump function of the left ventricle, and diastolic dysfunction, which implies inadequate filling of the left ventricle.

To investigate associations of retinopathy with changes in left ventricular systolic and diastolic function, the researchers performed echocardiography and carried

out a linear regression analysis adjusting the results for age and gender and traditional risk factors for heart failure.

“The pathogenesis of heart failure is still unclear. It is known that a person who smokes, who is overweight, has hypertension and/or has diabetes is at an increased risk of developing heart failure. However, these traditional risk factors do not explain the complete risk and even in the absence of these risk factors there still can remain a significant risk of developing heart failure,” Ms Walraven said.

One theory that has gained some support in recent years is that there is a link between microvascular dysfunction and coronary dysfunction. The idea is that microvascular dysfunction reflects a low-grade inflammatory state of the body, which is itself a risk factor for the development of heart failure. Furthermore, recent research has shown that microaneurysms, a frequent feature in eyes with retinopathy, are also found in post-mortem hearts that suffered from heart failure.

“The next question is, should we screen everyone who has retinopathy for left ventricular dysfunction? I would be careful how I answered that question and say that the next step is to validate this study in a larger study population,” Ms Walraven added.

RETINOPATHY Retinopathy as a sign of future heart failureby Roibeard O’hEineachain in Dublin

Iris Walraven – [email protected]

contact

Update

RETINa

Should we screen everyone who has retinopathy for left ventricular dysfunction? I would be careful how I answered that question...”

“

Iris Walraven

Don’t Miss Research update, see page 33