Semi-automatic measuring of arteriovenous relation as a possible silent brain infarction risk index in hypertensive patients.
OBJECTIVE
To evaluate the usefulness of a semiautomatic measuring system of arteriovenous relation (RAV) from retinographic images of hypertensive patients in assessing their cardiovascular risk and silent brain ischemia (ICS) detection.


METHODS
Semi-automatic measurement of arterial and venous width were performed with the aid of Imedos software and conventional fundus examination from the analysis of retinal images belonging to the 976 patients integrated in the cohort Investigating Silent Strokes in Hypertensives: a magnetic resonance imaging study (ISSYS), group of hypertensive patients. All patients have been subjected to a cranial magnetic resonance imaging (RMN) to assess the presence or absence of brain silent infarct.


RESULTS
Retinal images of 768 patients were studied. Among the clinical findings observed, association with ICS was only detected in patients with microaneurysms (OR 2.50; 95% CI: 1.05-5.98) or altered RAV (<0.666) (OR: 4.22; 95% CI: 2.56-6.96). In multivariate logistic regression analysis adjusted by age and sex, only altered RAV continued demonstrating as a risk factor (OR: 3.70; 95% CI: 2.21-6.18).


CONCLUSIONS
The results show that the semiautomatic analysis of the retinal vasculature from retinal images has the potential to be considered as an important vascular risk factor in hypertensive population.
Secció d'Oftalmologia, Hospital Municipal de Badalona, Badalona Serveis Assistencials , Badalona (Barcelona), España. Electronic address: oftxose@yahoo.com.
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Vázquez Dorrego
Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol, Santa Coloma de Gramenet, Barcelona, España; Departament d'Infermeria, Universitat Autònoma de Barcelona, Cerdanyola del Vallès (Barcelona), España.
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Manresa Domínguez
Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol, Santa Coloma de Gramenet, Barcelona, España; ABS Riu Nord-Riu Sud, Institut Català de la Salut, Santa Coloma de Gramenet (Barcelona), España.
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Heras Tebar
Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol, Santa Coloma de Gramenet, Barcelona, España; ABS Riu Nord-Riu Sud, Institut Català de la Salut, Santa Coloma de Gramenet (Barcelona), España.
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Forés
Servei de Urgències, Hospital de Barcelona, Barcelona, España.
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Girona Marcé
Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol, Santa Coloma de Gramenet, Barcelona, España; ABS Riu Nord-Riu Sud, Institut Català de la Salut, Santa Coloma de Gramenet (Barcelona), España.
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Alzamora Sas
Laboratori de Malalties Neurovasculars, Institut de Recerca Vall d'Hebron, Institut Català de la Salut, Barcelona, España; Universitat Autònoma de Barcelona (UAB), Barcelona, España.
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Delgado Martínez
Laboratori de Malalties Neurovasculars, Institut de Recerca Vall d'Hebron, Institut Català de la Salut, Barcelona, España; Universitat Autònoma de Barcelona (UAB), Barcelona, España.
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Riba-Llena
Promoción e I+D+I, ULMA Innovación SL, Oñati (Gipúzcoa), España.
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Ugarte Anduaga
Vicomtech-IK4 Visual Interaction Communication Technologies, San Sebastián (Guipúzcoa), España.
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Beristain Iraola
Vicomtech-IK4 Visual Interaction Communication Technologies, San Sebastián (Guipúzcoa), España.
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Barandiaran Martirena
Hospital Universitari Germans Trias i Pujol, Badalona (Barcelona), España.
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Ruiz Bilbao
Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol, Santa Coloma de Gramenet, Barcelona, España; Departament de Medicina, Universitat de Girona, Gerona, España.
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Torán Monserrat
D000368:Aged; D001160:Arterioles / Q000473:pathology; D001331:Automation; D020520:Brain Infarction / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000473:pathology; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012171:Retinal Vessels / Q000473:pathology*; D042262:Retinoscopy / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors; D012984:Software; D014699:Venules / Q000473:pathology
Arterial hypertension; Arteriole to venule ratio; Eye fundus; Fondo de ojo; Hipertensión arterial; Ictus; Isquemia cerebral silente; Medición semiautomática de la microcirculación retiniana; Ratio arteria vena; Retinografía; Retinography; Retinopathy; Retinopatía; Semi-automatic retinal vessel quantification; Silent brain infarct; Stroke