Pulse Waveform Analysis in Ocular Microcirculation by Laser Speckle Flowgraphy in Patients with Left Ventricular Systolic and Diastolic Dysfunction

PURPOSE: To determine: (1) whether variables of a pulse wave form analysis of ocular microcirculation shown by laser speckle flowgraphy (LSFG) correlate with left ventricular (LV) systolic dysfunction and (2) whether these variables correlate with LV diastolic dysfunction in subjects without LV systolic dysfunction as assessed by echocardiography. METHODS: We studied 200 consecutive subjects. LV systolic dysfunction has been determined to be present when the LV ejection fraction was < 50%. LV diastolic dysfunction was diagnosed when subjects had an E/e' ratio ≥15 and an e' velocity < 10 cm/s. We evaluated the pulse waveform analysis variables "rising rate" and the blowout score (BOS) using LSFG in the optic nerve head (ONH) and choroid. RESULTS: The brain natriuretic peptide (BNP) level, the rising rate in the choroid area (rising rate-choroid), and heart rate were revealed as independent factors for LV systolic dysfunction, and BOS-choroid was identified as an independent factor for LV diastolic dysfunction. The areas under the curve (AUC) of BNP and rising rate-choroid for LV systolic dysfunction were 0.83 and 0.81, respectively. The AUC of BOS-choroid for LV diastolic dysfunction was 0.73. CONCLUSION: Pulse waveform analysis in the choroid has a significant correlation with LV systolic and LV diastolic function.