Eye Health

19 November 2013

Eyes may indicate atrial fibrillation risk

Damage to the blood vessels of the eyes or kidneys might help identify people who are at raised risk for a common type of heart-rhythm disorder.

Damage to the blood vessels of the eyes or kidneys might help identify people who are at raised risk for a common type of heart-rhythm disorder, a new study suggests.

The disorder, called atrial fibrillation, is common in older people and increases the risk of stroke. It also can trigger heart-related chest pain or heart failure in some patients, the researchers said.

In the new study, which is scheduled for presentation at the annual meeting of the American Heart Association in Dallas, researchers followed more than 10 000 middle-aged people for an average of almost 14 years.

Researchers led by Sunil Agarwal, of Johns Hopkins University in Baltimore, found that micro vascular changes – trouble in the smaller vessels of the eyes or kidneys – appeared to be linked to the presence of atrial fibrillation.

For example, while about six out of every 1000 people with no micro vascular disease developed the heart-rhythm disorder, that figure rose to about nine out of every 1000 for people with micro-bleeds or micro-aneurysms in the smaller vessels of the eye's retina, the researchers said.

That number rose to almost 17 per 1000 people for those with signs of vessel damage in the kidneys. It increased to more than 24 per 1000 in people who had vessel damage in both the eyes and kidneys, the study found.

Unclear connection

Why this vessel damage appears to be tied to a higher risk for atrial fibrillation remains unclear, the researchers said.

One expert not connected to the study theorised that small-vessel damage might be an underlying cause of atrial fibrillation.

"This [study] suggests that a potential trigger for developing atrial fibrillation may be worsening micro vascular disease," said Dr Neil Sanghvi, an electro physiologist at Lenox Hill Hospital in New York City. "Therefore, treatments that are able to minimise or prevent micro vascular damage may be able to decrease the incidence of atria fibrillation."

Dr Kenneth Ong is interim chief of cardiology at the Brooklyn Hospital Centre in New York City. "Damage to the vessels in the eyes and kidneys are thought to reflect similar findings in the rest of the body, including the heart," he said.

He added that it's "reasonable to speculate" that patients with such damage might be at higher risk for heart disease.

Sanghvi said patients who have vessel damage in the eyes or kidneys "should consider long-term monitoring, on the order of one or two weeks," to gauge their risk for undetected atrial fibrillation.

More information

The US National Heart, Lung, and Blood Institute has more about atrial fibrillation.

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Megan Goodman qualified as an optometrist from the University of Johannesburg and is currently practising at Tygerberg Academic Hospital in Cape Town. She has recently completed a Masters degree in Clinical Epidemiology at Stellenbosch University. She has a keen interest in ocular pathology and evidence based medicine as well as contact lenses.

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