Ocular choroidal thickness reflects systemic recovery after acute heart failure: a pilot observational study

The choroid has been proposed as a surrogate marker for systemic hemodynamics, but changes in subfoveal choroidal thickness (CCT) before and after acute heart failure (AHF) treatment remain largely unexplored. We conducted a prospective observational study involving 25 patients admitted for AHF treatment at Nihon University Hospital. Ophthalmologic evaluation of CCT, blood tests (including Controlling Nutritional Status [CONUT] score), and body composition measurements were performed at two time points: during the subacute phase of hospitalization and prior to discharge. The primary endpoint was the correlation between the change in choroidal thickness (ΔCCT) and nutritional and renal function markers. Overall, CCT increased from admission to pre-discharge (200 ± 78 to 209 ± 81 μm; P = 0.03). In HFrEF (n = 12), ΔCCT correlated with ΔCONUT (r = 0.67; 95% CI 0.16–0.90) and eGFRcys (r = 0.73; 95% CI 0.27–0.92) in univariate analyses and remained independently associated with both in multivariable models (ΔCONUT: B = 3.02; 95% CI 0.21–5.84; P = 0.039; eGFRcys: B = 0.60; 95% CI 0.06–1.14; P = 0.034). Changes in CCT after AHF treatment are consistent with systemic recovery. In HFrEF, both ΔCONUT and eGFRcys were independently associated with ΔCCT, supporting CCT as a feasible, noninvasive adjunct biomarker for monitoring recovery during heart-failure management.