目的:描述运动负荷试验(ET)后患者的视网膜和脉络膜血管的变化,并确定光学相干断层扫描血管造影(OCT-A)是否在预测缺血性心脏事件中发挥作用。
方法:前瞻性比较研究,包括劳力性心绞痛患者。所有患者在进行ET之前和之后均接受OCT-A。血流量,毛细管间空间,分析了浅毛细血管丛(SCP)和深毛细血管丛(DCP)的血管密度。还分析了脉络膜毛细血管的血管密度和中央无血管区(CAZ)的参数。
结果:在纳入研究的38只眼中,在大型SCP血管中发现39.5%的血流减少,在SCP毛细血管的50%中,在DCP中占81.6%。在68.4%的眼睛中的SCP和55.3%的DCP中观察到毛细管间隙的增加。ET后观察到DCP密度的统计学显着降低(p=0.03)。CAZ参数没有显著变化,SCP密度,也没有脉络膜的密度。ET阳性的患者DCP密度降低了83.3%。在DCP密度增加的患者中,92.85%的患者ET阴性。
结论:这项初步研究表明,ET后DCP密度显着降低。在劳力性心绞痛患者中,DCP似乎受影响最大。需要更大的试验来进一步研究这些假设。
OBJECTIVE: To describe retinal and choroidal vascular changes following an exercise stress test (ET) in patients with effort angina and to determine whether optical coherence tomography angiography (OCT-A) could play a role in the prediction of ischemic cardiac events.
METHODS: Prospective comparative study including patients with effort angina. All patients underwent OCT-A before and after an ET was performed. Blood flow, intercapillary spaces, and vessel density were analyzed in the superficial capillary plexus (SCP) and the deep capillary plexus (DCP). Vessel density in the choriocapillaris and the parameters of the central avascular zone (CAZ) were also analyzed.
RESULTS: Of the 38 eyes included in the study, a decrease in blood flow was found in 39.5% in the large SCP vessels, in 50% in the capillaris of the SCP, and in 81.6% in the DCP. An increase in intercapillary spaces was observed in the SCP in 68.4% of eyes and in the DCP in 55.3% of eyes. A statistically significant decrease in the DCP density was observed after an ET (p = 0.03). There were no significant modifications in the CAZ parameters, the SCP density, nor the choriocapillaris density. Patients with a positive ET had a decreased DCP density in 83.3%. Among patients with an increased DCP density, 92.85% had a negatif ET.
CONCLUSIONS: This pilot study suggests that DCP density significantly decreases after an ET. The DCP appears to be most affected in patients with effort angina. A larger trial is needed to further investigate these hypotheses.