Correlation between diastolic function and fundus vascular features in coronary heart disease

AIM: To assess the correlation between cardiac diastolic function and retinal/choroidal vascular features in patients with coronary heart disease (CHD). METHODS: This observational clinical cohort study included 206 CHD patients (412 eyes). Optical coherence tomography (OCT) and OCT angiography (OCTA) images were obtained from each participant using the AngioVue Imaging System. Each patient also underwent echocardiography to evaluate cardiac diastolic function. RESULTS: Several correlations were found between cardiac diastolic function and fundus vascular features in CHD patients. Left ventricular end-diastolic diameter (LVED), interventricular septal thickness in diastole (IVSD), left ventricular posterior wall thickness in diastole (LVPWD), and early (E) to atrial (A) wave velocity (E/A ratio) positively correlated with retinal thickness, while early (E) diastolic mitral inflow velocity to early (E') diastolic mitral annular velocity (E/E' ratio) and pulmonary arterial systolic pressure (PASP) negatively correlated. Significant associations were noted for LVED and PASP across several retinal regions, excluding the foveal central subfield. Vessel density in superficial capillary plexus (SCP) and deep capillary plexus (DCP) layers had negative correlations with IVSD, LVPWD, and E/E' ratio, but a positive correlation with E/A ratio. The choriocapillaris (CC) layer's vessel density positively correlated with the E/A ratio and negatively with the E/E' ratio. LVPWD and E/A ratio positively correlated with choroidal perfusion, while E/E' ratio showed a negative correlation. LVED, pulmonary artery diameter (PA), and PASP showed no significant associations with retinal or choroidal perfusion. CONCLUSION: In CHD patients, macular retinal/choroidal thickness, vascular density across different layers, and perfusion may serve as useful and sensitive predictors of fundus circulatory disturbances resulting from impaired cardiac diastolic function.