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. 2022 Apr 21;12(1):6545.
doi: 10.1038/s41598-022-10491-7.

A novel algorithm for cardiovascular screening using conjunctival microcirculatory parameters and blood biomarkers

Agnes Awuah  1 , Julie S Moore  1 , M Andrew Nesbit  1 , Mark W Ruddock  2 , Paul F Brennan  3 , Jonathan A Mailey  3 , Andrew J McNeil  4 , Min Jing  5 , Dewar D Finlay  5 , Emanuele Trucco  4 , Mary Jo Kurth  2 , Joanne Watt  2 , John V Lamont  2 , Peter Fitzgerald  2 , Mark S Spence  3 , James A D McLaughlin  5 , Tara C B Moore  6
Affiliations

A novel algorithm for cardiovascular screening using conjunctival microcirculatory parameters and blood biomarkers

Agnes Awuah et al. Sci Rep. .

Abstract

Microvascular haemodynamic alterations are associated with coronary artery disease (CAD). The conjunctival microcirculation can easily be assessed non-invasively. However, the microcirculation of the conjunctiva has not been previously explored in clinical algorithms aimed at identifying patients with CAD. This case-control study involved 66 patients with post-myocardial infarction and 66 gender-matched healthy controls. Haemodynamic properties of the conjunctival microcirculation were assessed with a validated iPhone and slit lamp-based imaging tool. Haemodynamic properties were extracted with semi-automated software and compared between groups. Biomarkers implicated in the development of CAD were assessed in combination with conjunctival microcirculatory parameters. The conjunctival blood vessel parameters and biomarkers were used to derive an algorithm to aid in the screening of patients for CAD. Conjunctival blood velocity measured in combination with the blood biomarkers (N-terminal pro-brain natriuretic peptide and adiponectin) had an area under receiver operator characteristic curve (AUROC) of 0.967, sensitivity 93.0%, specificity 91.5% for CAD. This study demonstrated that the novel algorithm which included a combination of conjunctival blood vessel haemodynamic properties, and blood-based biomarkers could be used as a potential screening tool for CAD and should be validated for potential utility in asymptomatic individuals.

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Conflict of interest statement

Mark Ruddock, Mary Jo Kurth, Joanne Watt, and John Lamont are employees of Randox Laboratories Ltd but hold no shares in the Company. Peter Fitzgerald is the Managing Director and owner of Randox Laboratories Ltd. A patent has been filed to protect the biomarkers and biomarker combinations disclosed in this study.

Figures

Figure 1
Figure 1
Vessel parameter data collection. RE Right Eye, LE Left Eye, EDT Euclidean Distance Transform, 1D + T 1 Dimension + Time, CWT Continuous Wavelet Transform, Vs Cross Sectional Velocity, D Diameter.
Figure 2
Figure 2
ROC curve of ocular-biochemical score.
See this image and copyright information in PMC

References

    1. Institute of Health Metrix and Evaluations [IHME]. Global burden of disease study 2017. Lancet (2017).
    1. Braun MM, Stevens WA. Stable coronary artery disease: Treatment. Am. Fam. Physician. 2018;97:376–384. - PubMed
    1. British Heart Foundation. UK Factsheet, 1–21 (British Heart Foundation, 2020).
    1. World Economic Forum. The Global Economic Burden of Non-communicable Diseases, Harvard School of Public Health. (2011).
    1. Wilkins E, et al. European Cardiovascular Disease Statistics 2017 edition. European Heart Network; 2017. p. 192.