title: Relationship of ocular microcirculation, measured by laser speckle flowgraphy, and silent brain infarction in primary aldosteronism.
abstract: OBJECTIVE
  Recent studies have shown that the risk of cerebro- and cardiovascular events (CVEs) is higher in patients with primary aldosteronism (PA) than in those with essential hypertension (EH), and that silent brain infarction (SBI) is a risk factor and predictor of CVEs. Here, we evaluated the relationship between findings from laser speckle flowgraphy (LSFG), a recently introduced non-invasive means of measuring mean blur rate (MBR), an important biomarker of ocular blood flow, and the occurrence of SBI in patients with PA.
  
  
  METHODS
  87 PA patients without symptomatic cerebral events (mean 55.1 ± 11.2 years old, 48 male and 39 female) were enrolled in this study. We measured MBR in the optic nerve head (ONH) with LSFG and checked the occurrence of SBI with magnetic resonance imaging. We examined three MBR waveform variables: skew, blowout score (BOS) and blowout time (BOT). We also recorded clinical findings, including age, blood pressure, and plasma aldosterone concentration.
  
  
  RESULTS
  PA patients with SBI (15 of 87 patients; 17%) were significantly older and had significantly lower BOT in the capillary area of the ONH than the patients without SBI (P = 0.02 and P = 0.03, respectively). Multiple logistic regression analysis revealed that age and BOT were independent factors for the presence of SBI in PA patients (OR, 1.15, 95% CI 1.01-1.38; P = .03 and OR, 0.73, 95% CI 0.45-0.99; P = .04, respectively).
  
  
  CONCLUSIONS
  PA patients with SBI were older and had lower MBR BOT than those without SBI. Our analysis showed that age was a risk factor for SBI, and that BOT was a protective factor, in patients with PA. This suggests that BOT, a non-invasive and objective biomarker, may be a useful predictor of SBI and form part of future PA evaluations and clinical decision-making.
authors: Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Hiroshi
authors: H
authors: Kunikata
authors: Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Naoko
authors: N
authors: Aizawa
authors: Division of Nephrology, Endocrinology, and Vascular Medicine, Department of Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Masataka
authors: M
authors: Kudo
authors: Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Shunji
authors: S
authors: Mugikura
authors: Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Fumihiko
authors: F
authors: Nitta
authors: Division of Nephrology, Endocrinology, and Vascular Medicine, Department of Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Ryo
authors: R
authors: Morimoto
authors: Division of Nephrology, Endocrinology, and Vascular Medicine, Department of Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Yoshitsugu
authors: Y
authors: Iwakura
authors: Division of Nephrology, Endocrinology, and Vascular Medicine, Department of Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Yoshikiyo
authors: Y
authors: Ono
authors: Division of Nephrology, Endocrinology, and Vascular Medicine, Department of Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Fumitoshi
authors: F
authors: Satoh
authors: Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Hidetoshi
authors: H
authors: Takahashi
authors: Division of Nephrology, Endocrinology, and Vascular Medicine, Department of Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Sadayoshi
authors: S
authors: Ito
authors: Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Shoki
authors: S
authors: Takahashi
authors: Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Toru
authors: T
authors: Nakazawa
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D058070:Asymptomatic Diseases; D001794:Blood Pressure; D020520:Brain Infarction / Q000175:diagnosis / Q000209:etiology*; D005123:Eye / Q000098:blood supply*; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications* / Q000503:physiopathology*; D017078:Laser-Doppler Flowmetry; D008279:Magnetic Resonance Imaging; D008297:Male; D008833:Microcirculation; D008875:Middle Aged