Assessment of myocardial ischaemia using tissue Doppler imaging in pseudoexfoliation syndrome

• Published in: Eye (London) Vol. 25; no. 9; pp. 1177 - 1180
• Main Authors: Demir, N, Ulus, T, Yucel, O E, Kumral, E T, Singar, E, Tanboga, H I
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.09.2011; Nature Publishing Group
• Subjects: 631/443/592/1939; 692/699; 692/700/1421/1860/1445; Aged; Biological and medical sciences; Blood Flow Velocity - physiology; Cardiology. Vascular system; Clinical Study; Coronary heart disease; Echocardiography, Doppler; Exfoliation Syndrome - diagnostic imaging; Exfoliation Syndrome - physiopathology; Female; Heart; Humans; Laboratory Medicine; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Miscellaneous; Mitral Valve - diagnostic imaging; Mitral Valve - physiopathology; Myocardial Ischemia - diagnostic imaging; Myocardial Ischemia - physiopathology; Myocarditis. Cardiomyopathies; Ophthalmology; Pharmaceutical Sciences/Technology; Surgery; Surgical Oncology; Systole - physiology; myocardial ischaemia; exfoliation syndrome; myocardial perfusion imaging; Sonography; Tissue doppler; Cardiovascular disease; Myocardial ischemia; Coronary heart disease; Myocardial disease; Vascular disease; Perfusion imaging; Myocardium; Ophthalmology; Lens pseudoexfoliation
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/eye.2011.145

Purpose Pseudoexfoliation (PEX) syndrome is characterized by the widespread deposition of abnormal extracellular fibrillary material on many ocular and extraocular tissues. We aimed to investigate the association between PEX syndrome and subclinical myocardial ischaemia, using tissue Doppler echocardiography. Methods Thirty-two patients with pseudoexfoliation syndrome (mean age: 66±9 years, 22 men) and 25 healthy individuals (mean age: 67±8 years, 13 men) were included in the study. Patients with overt coronary artery disease, congestive heart failure, valvular heart disease, cardiomyopathy, and left ventricular hypertrophy were excluded from the study. Tissue Doppler imaging was performed at the septal, lateral, anterior, and inferior mitral annuluses. Differences between the groups were evaluated by the unpaired t -test and the Mann–Whitney U -test, with a P -value of <0.05 considered significant. Results Baseline clinical characteristics, two-dimensional, and Doppler echocardiography parameters were similar in the PEX and control groups. Peak systolic velocities at the septal, lateral, anterior, and inferior annuluses were significantly lower in patients with PEX syndrome ( P <0.001, 0.01, 0.02, and 0.02, respectively). The early diastolic velocity at the septal annulus, and the ratio of early/late diastolic velocity at the lateral annulus were significantly lower in the study group ( P =0.03). Conclusion PEX syndrome is a common disorder of extracellular matrix. Our data suggest that there may also be an association between PEX syndrome and subclinical myocardial ischaemia in patients who have no signs and symptoms of ischaemia. Thus, we think that ophthalmologists should consider informing their PEX syndrome patients' general practitioners about a possible cardiac risk.