Can Pupil Size Predict Mortality and Readmission in Heart Failure Patients? Research says it can

Globally, an estimated 26 million people are currently living with heart failure. This is a life-threatening condition in which the heart cannot pump enough blood to meet the body’s needs. It is important to find better ways to identify patients who are likely to be rehospitalized or die in this condition, and the researchers predict that death and rehospitalization in people with heart failure will occur. I have found

“Our results suggest that the pupillary region is a new way to identify patients with hearts who are at increased risk of death or hospitalization. This provides the opportunity to intervene and improve their outlook. “Masu,” said Dr. Kohei Nozaki of Kitasato University Hospital, Kanagawa Prefecture, who is the research author. of Investigation result Published in ESC Heart Failure, the journal of the European Heart Association (ESC).

According to the authors, heart failure is one of the leading causes of death worldwide, and people’s symptoms include shortness of breath, swelling of the limbs, and fatigue. They added that up to 45% of patients hospitalized for heart failure die within 1 year of admission and the majority die within 5 years of admission. “One of the causes of worsening heart failure is the dysfunction of the body’s autonomic nervous system, which controls heart rate, digestion, respiration, etc. Autonomic nervous function is usually assessed by measuring changes in heart rate. However, this method does not work for patients with a heart rhythm disorder called atrial fibrillation, which is common in patients with heart failure,” the team writes.

Researchers say that the pupillary area is another method of assessing autonomic function, which is used in patients with Parkinson’s disease and diabetes. Therefore, they investigated whether the pupillary region could predict the prognosis of heart failure patients.

The study was conducted on 870 patients hospitalized for acute heart failure between 2012 and 2017. The average age was 67, and 37% were female. Pupillary area was measured in both eyes at least 7 days after admission. In the test, patients put on goggles, wait 5 minutes for their eyes to darken, and then took a picture of their eyes. Patients were tested at standard time (between 9am and 12pm) as the autonomous system is time sensitive.

Patients were divided into small and large pupillary area groups based on whether the measurements were below or above the median (16.6 mm2). Subsequently, all-cause mortality (primary endpoint) and readmission for heart failure (secondary endpoint) were followed up. We compared the results of the small and large pupil region groups.

The authors found that “eye pictures provide a prediction of longevity” in patients with heart failure. Patients in the small pupillary region group had significantly lower survival rates and significantly higher readmission rates for heart failure compared to the large pupillary region group. Over a median follow-up of 1.9 years, 131 patients died of heart failure: 87 or 20% of 434 in the small pupil area group and 44 or 10.1% of 44 in the large pupil area group. Cardiovascular death occurred in 90 patients. The incidence of cardiovascular death in patients with small pupil area was significantly higher (61 or 14.1%), compared with 29 or 6.7% in the group with large pupil area.

The analysis also shows that 328 was readmitted for heart failure. This includes 205 (47.2%) in the small pupil region group and 123 (28.2%) in the large pupil region group. Large pupil area is consistently associated with favorable survival regardless of age, gender, presence of normal heart rhythm or atrial fibrillation (irregular and often rapid heart rate). “Pupil area was independently associated with all-cause mortality (hazard ratio: 0.72) and readmission for heart failure (hazard ratio: 0.82) after adjusting for some existing prognostic factors, including the Seattle Heart Failure Score (SHFS) The authors conclude.” However, the research team emphasizes that the pupillary region cannot be used in patients with severe retinopathy or other eye disorders.

“Pupil area can be obtained quickly, easily and non-invasively. Our study could be used in routine practice to predict the prognosis of heart failure patients, including those with heart failure who also have atrial fibrillation. Patients with small pupil area (eg, <16.6 mm2) can prioritize cardiac rehabilitation with physical activity reported to improve autonomic function.” Dr. Nozaki recommends.

Disclaimer: This article is for informational purposes only and does not replace professional medical advice, diagnosis or treatment. If you have questions about a medical condition, always seek the advice of a doctor or other qualified healthcare provider.