title: Altered blood vessel responses in the eye and finger in coronary artery disease.
abstract: OBJECTIVE
  Cardiac function, such as heart rate variability, is abnormal in coronary artery disease, but its relation with the function of ocular and nail-fold blood vessels is unknown. The hypothesis was that there is abnormal retinal and peripheral microvascular endothelial function compared with large blood vessel and cardiac function. Twenty-four patients with coronary artery disease (CAD) and 30 healthy, age- and sex-matched control subjects were enrolled in the study.
  
  
  METHODS
  Peripheral microcirculatory function was measured with continuous retinal vessel diameter assessment and nail-fold capillaroscopy. Systemic vascular function was evaluated by 24-hour blood pressure, arterial stiffness, low (LF)- and high (HF)-frequency heart rate variability, ECG monitoring, and the plasma markers von Willebrand factor (vWf) and soluble E selectin.
  
  
  RESULTS
  Peripheral nail-fold capillary (P = 0.009) and retinal vessel (average baseline corrected flicker response [BFR]; P = 0.034) responses and reaction time in response to flicker (P = 0.016) were significantly different in patients compared with controls. Furthermore, patients demonstrated higher arterial stiffness (P = 0.005), LF and HF heart rate variability (P = 0.004, P = 0.006), and vWf level (P = 0.044), but there was no difference in soluble E selectin level (P = 0.278). In the CAD patients, LF and HF heart rate variability both correlated with average BFR (r = 0.58, P = 0.004; r = -0.6, P = 0.003, respectively). There was no such relationship in the healthy controls.
  
  
  CONCLUSIONS
  Microcirculatory abnormalities of the retina and nail-fold vessels are present in CAD. The two indices of heart rate variability correlated with an index of ocular vessel responses. The latter may be a surrogate marker of abnormal heart rate variability in CAD.
authors.affiliation: Aston University, School of Life and Health Sciences, Birmingham, United Kingdom. r.heitmar1@aston.ac.uk
authors.forename: Rebekka
authors.initials: R
authors.lastname: Heitmar
authors.forename: Robert P
authors.initials: RP
authors.lastname: Cubbidge
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
authors.forename: Doina
authors.initials: D
authors.lastname: Gherghel
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Blann
mesh_terms: D001783:Blood Flow Velocity; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D019842:Ciliary Arteries / Q000503:physiopathology*; D003324:Coronary Artery Disease / Q000503:physiopathology*; D019040:E-Selectin / Q000097:blood; D004562:Electrocardiography; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000503:physiopathology*; D012161:Retinal Artery / Q000503:physiopathology*; D016683:Supine Position; D014841:von Willebrand Factor / Q000378:metabolism
chemical_list: D019040:E-Selectin; D014841:von Willebrand Factor