Severity Stratification of Coronary Artery Disease Using Novel Inner Ellipse-Based Foveal Avascular Zone Biomarkers.

IF 5 2区 医学 Q1 OPHTHALMOLOGY
Natasa Jeremic, Maximilian Pawloff, Dmitrii Lachinov, Stephanie Rokitansky, Matthias Hasun, Franz Weidinger, Andreas Pollreisz, Hrvoje Bogunovic, Ursula Schmidt-Erfurth
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Abstract

Purpose: Given the similarities between the retinal and coronary microvasculature, the retina holds promising potential to serve as a non-invasive screening tool for coronary artery disease (CAD). We aimed to develop novel inner ellipse-based metrics and discern whether foveal avascular zone (FAZ) alterations can serve as indicators for CAD presence and severity.

Methods: Patients admitted to the Department of Cardiology who underwent coronary angiography were included. This resulted in an inclusion of 212 patients, of which 73 had no CAD. During the same visit, 6 × 6-mm (nominal size) fovea-centered optical coherence tomography angiography images of both eyes were acquired. The Gensini score (GS) was utilized to quantify CAD severity. Six known FAZ shape metrics were assessed and three novel biomarkers based on the inner ellipse were defined: absolute inner ellipse difference, Hausdorff distance, and Chamfer distance.

Results: Eight out of nine metrics showed significant associations with the GS in the left eye. However, significant differences across three CAD severity groups were only demonstrated by the novel metrics. Utilizing the Chamfer distance, age, and sex, patients with and without CAD could be distinguished with an average area under the curve (AUC) of 0.89 (95% confidence interval [CI], 0.84-0.95). Moreover, three CAD severity groups could be discerned with a macro average AUC of 0.77 (95% CI, 0.72-0.84).

Conclusions: A comprehensive assessment of FAZ shape descriptors was performed, and a strong association with CAD was found. The inner ellipse-based biomarkers especially demonstrated high predictive abilities for CAD presence and severity.

利用基于内椭圆的新型眼窝血管区生物标记物对冠状动脉疾病进行严重程度分级
目的:鉴于视网膜和冠状动脉微血管之间的相似性,视网膜有望成为冠状动脉疾病(CAD)的无创筛查工具。我们的目的是开发基于内椭圆的新指标,并确定眼窝无血管区(FAZ)的改变是否可作为冠状动脉疾病存在和严重程度的指标:方法:纳入心内科接受冠状动脉造影术的患者。方法:纳入心脏病科住院并接受冠状动脉造影术的患者,共纳入 212 例患者,其中 73 例无 CAD。在同一次就诊中,采集了以眼窝为中心的 6 × 6 毫米(标称尺寸)双眼光学相干断层血管造影图像。詹西尼评分(GS)用于量化 CAD 的严重程度。评估了六个已知的FAZ形状指标,并定义了三个基于内椭圆的新型生物标志物:绝对内椭圆差、豪斯多夫距离和倒角距离:结果:九项指标中有八项与左眼GS有显著关联。然而,只有新的度量指标在三个 CAD 严重程度组别中显示出明显差异。利用倒角距离、年龄和性别,可以区分有无 CAD 的患者,平均曲线下面积 (AUC) 为 0.89(95% 置信区间 [CI],0.84-0.95)。此外,宏观平均曲线下面积(AUC)为 0.77(95% 置信区间 [CI],0.72-0.84),可区分出三个 CAD 严重程度组别:结论:对FAZ形状描述因子进行了全面评估,发现其与CAD有密切关系。结论:该研究对 FAZ 形状描述因子进行了全面评估,发现其与冠状动脉粥样硬化有很强的相关性。
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来源期刊
CiteScore
6.90
自引率
4.50%
发文量
339
审稿时长
1 months
期刊介绍: Investigative Ophthalmology & Visual Science (IOVS), published as ready online, is a peer-reviewed academic journal of the Association for Research in Vision and Ophthalmology (ARVO). IOVS features original research, mostly pertaining to clinical and laboratory ophthalmology and vision research in general.
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