Relationships between retinal arteriole anatomy and aortic geometry and function and peripheral resistance in hypertensives

David Rosenbaum (1, 2, 3) , Nadjia Kachenoura (1) , Edouard Koch (4, 5) , Michel Pâques (4, 5) , Philippe Cluzel (2, 1, 3) , Alban Redheuil (2, 1, 3) , Xavier Girerd (2)

1 LIB - Laboratoire d'Imagerie Biomédicale [Paris]
2 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
3 CHU Pitié-Salpêtrière [AP-HP]
4 Institut de la Vision
5 CHNO - Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts

Microvascular remodeling and large artery stiffness are key determinants of cardiovascular hemodynamics and can now be studied with new non-invasive methods. Our objective was to study the relationships between retinal arteriole anatomy and aortic geometry and function and peripheral resistance (total peripheral resistance (TPR)) in hypertensives. In 80 subjects (age 52±13 years; 53% males; including 23 normotensives and 57 hypertensives, among which 29 were uncontrolled hypertensives), we used: (1) the new non-invasive RTX1 adaptive optics (AO) camera (Imagine Eyes, Orsay, France) to measure the wall-to-lumen ratio (WLR) on retinal microvasculature; (2) cardiovascular magnetic resonance (CMR) imaging to assess aortic stiffness, geometry and cardiac output; and (3) the validated SphymoCor Xcel device to measure central blood pressure (BP) and carotido-femoral pulse wave velocity (Cf-PWV). TPR was calculated as the central mean BP/cardiac output ratio. WLR and TPR were significantly higher and aortic distensibility was significantly lower in hypertensives. Aortic dilation and arch elongation were found in uncontrolled hypertensives. In the univariate analysis, WLR was positively correlated with central BP (P<0.001), TPR (P<0.001) and Cf-PWV (P<0.05), and it was negatively correlated with aortic distensibility (P=0.003); however, it was not correlated with age or cardiovascular risk factors. The multivariate analysis indicated that WLR was associated with TPR (P=0.002) independent of age, BMI, gender, antihypertensive treatments, aortic diameter and central SBP. As expected, age was the major correlate of ascending aorta distensibility and Cf-PWV. New non-invasive vascular imaging methods are complementary for the detection of the deleterious effects of aging or high BP on large and small arteries. AO examination could represent a useful tool for the study and follow-up of microvasculature anatomical changes.

Domaines: Sciences du Vivant [q-bio]; Médecine humaine et pathologie

David Rosenbaum, Nadjia Kachenoura, Edouard Koch, Michel Pâques, Philippe Cluzel, et al.. Relationships between retinal arteriole anatomy and aortic geometry and function and peripheral resistance in hypertensives. Hypertension Research, 2016, 39 (7), pp.536-542. ⟨10.1038/hr.2016.26⟩. ⟨hal-02635404⟩