Evaluation of left ventricular functions in patients with pseudoexfoliation syndrome using tissue Doppler echocardiography and its association with plasma BNP levels

Abstract

Objective: Pseudoexfoliation syndrome (PES) is a systemic disorder that involves various visceral organs. In this observational cross-sectional study we aimed to investigate the left ventricular functions in patients with PES by using tissue Doppler imaging and correlations between B-type natriuretic peptide levels and cardiac functions. Methods: The study enrolled 22 patients with PES (9 male, 41%), aged 57.0±8.8 years, and 23 control subjects (9 male, 39%), aged 52.8±4.9 years. Patients with any cardiovascular disease were excluded. Fasting blood samples were taken and tissue Doppler imaging was performed at the mitral annulus with echocardiographic examination. The independent t and Mann-Whitney U tests were used. Results: The Em velocities at the basal septum and lateral annulus were significantly lower in patients with PES showing decreased diastolic functions (7.6±2.0 versus 9.1±1.6 cm/s, p=0.01 and 9.3±3.5 versus 11.5±3.1 cm/s, p=0.04 respectively). While global left ventricular systolic function assessed by ejection fraction was not significantly different between patients with PES and controls, the septum S-wave velocities of PES patients were lower (7.6±1.3 versus 8.5±1.2 cm/s, p=0.03). Total plasma B-type natriuretic peptide (BNP) levels were significantly higher in PES patients (129.04±99.38 pg/mL versus 59.64±53.69 pg/mL; p=0.005) and there was a negative correlation between plasma BNP concentration and mitral annulus average Em velocities (r=-0.554, p=0.009). E/Em ratio was also significantly higher in PES patients (7.85±2.01 versus 6.64±1.48, p=0.03). Conclusion: In this study we showed decreased left ventricular diastolic functions correlated with plasma BNP levels in PES patients. Although further studies needed, evaluation and follow-up of PES patients in terms of left ventricular functions will be useful. (Anadolu Kardiyol Derg 2014; 14: 422-6)

Evaluation of left atrial function using two-dimensional speckle tracking echocardiography in end-stage renal disease patients with preserved left ventricular ejection fraction

“…Pulsed wave TDI examinations were performed according to the guidelines of the American Society of Echocardiography [11]. The ratio of the mitral early diastolic flow velocity (E) and the mitral annular early diastolic myocardial velocity (E') were calculated [12]. The ePCWP was calculated according to the following formula: ePCWP = 1.25(E/E') + 1.9 [13].…”

Pseudoexfoliation syndrome: Are the eyes the mirror of the heart?

“…15 In a study by Çiçek Yılmaz et al which consisted of 22 PEX patients and 23 volunteers, they determined that diastolic functions decreased in the PEX group compared to the control group and this decrease was negatively correlated with plasma BNP concentration. 17 The common feature of these studies is that systolic functions were evaluated only by the Simpson method, no significant change was detected, a moderate decrease in diastolic parameters was detected, and no significant diastolic dysfunction was detected. In a study of Ulus et al which was conducted on 32 PEX patients and 34 healthy volunteers, they detected changes in both transmitral flows with tissue doppler and shortening of isovolumetric contraction time in PEX patients, which is an indicator of systolic functions.…”

“…The results of these studies based on echocardiography have conflicting results in terms of systolic functions, diastolic functions, and subclinical ischemia findings. [13][14][15][16][17] Even though there was no significant impairment in left ventricular (LV) systolic functions, it was detected in long-term follow-up studies that it was associated with 1.5-fold increased cardiovascular (CV) events in recent years. 18 Speckle tracking echocardiography is an echocardiographic modality by which the movements of ultrasound signals are automatically tracked and which allows measurement of myocardial strain and reduces measurement errors compared to tissue Doppler imaging and by which all segments of the myocardium are evaluated.…”

Investigation of Possible Role of Chlamydia in Pseudoexfoliation Syndrome

“…However, this inflammatory reaction, which is necessary for bacterial clearance, also becomes a reason for immunopathology such as scarring and tissue damage (3). cellular material in intraocular and extraocular tissues (7,8). Due to the aggregation of pseudoexfoliation material in the eye, different complications such as weak pupillary dilation, cataract formation, pseudoexfoliative glaucoma (PEG), pseudouveitis, posterior synechia, and zonular weakness may occur (9).…”