Abstract
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.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Ritch R, Schlötzer-Schrehardt U . Exfoliation syndrome. Surv Ophthalmol 2001; 45 (4): 265–315.
Vesti E, Kivela T . Exfoliation syndrome and exfoliation glaucoma. Prog Retin Eye Res 2000; 19 (3): 345–368.
Streeten BW, Li ZY, Wallace RN, Eagle RC, Keshgegian AA . Pseudoexfoliative fibrillopathy in visceral organs of a patient with pseudoexfoliation syndrome. Arch Ophthalmol 1992; 110 (12): 1757–1762.
Schlotzer-Schrehardt U, Naumann GO . Ocular and systemic pseudoexfoliation syndrome. Am J Ophthalmol 2006; 141 (5): 921–937.
Citirik M, Acaroglu G, Batman C, Yildiran L, Zilelioglu O . A possible link between the pseudoexfoliation syndrome and coronary artery disease. Eye 2007; 21 (1): 11–15.
Andrikopoulos GK, Mela EK, Georgakopoulos CD, Papadopoulos GE, Damelou AN, Alexopoulos DK et al. Pseudoexfoliation syndrome prevalence in Greek patients with cataract and its association to glaucoma and coronary artery disease. Eye 2009; 23 (2): 442–447.
Thibault H, Derumeaux G . Assessment of myocardial ischemia and viability using tissue Doppler and deformation imaging: the lessons from the experimental studies. Arch Cardiovasc Dis 2008; 101 (1): 61–68.
Derumeaux G, Ovize M, Loufoua J, Pontier G, André-Fouet X, Cribier A . Assessment of nonuniformity of transmural myocardial velocities by color-coded tissue Doppler imaging: characterization of normal, ischemic, and stunned myocardium. Circulation 2000; 101 (12): 1390–1395.
Derumeaux G, Ovize M, Loufoua J, André-Fouet X, Minaire Y, Cribier A et al. Doppler tissue imaging quantitates regional wall motion during myocardial ischemia and reperfusion. Circulation 1998; 97 (19): 1970–1977.
Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography: American Society of Echocardiography committee on standards, subcommittee on quantitation of two-dimensional echocardiograms. J Am Soc Echocardiogr 1989; 2: 358–367.
Repo LP, Teräsvirta ME, Koivisto KJ . Generalized transluminance of the iris and the frequency of the pseudoexfoliation syndrome in the eyes of transient ischemic attack patients. Ophthalmology 1993; 100 (3): 352–355.
Mitchell P, Wang JJ, Smith W . Association of pseudoexfoliation syndrome with increased vascular risk. Am J Ophthalmol 1997; 124 (5): 685–687.
Schumacher S, Schlotzer-Schrehardt U, Martus P, Lang W, Naumann GO . Pseudoexfoliation syndrome and aneurysms of the abdominal aorta. Lancet 2001; 357 (9253): 359–360.
Bojic L, Ermacora R, Polic S, Ivanisevic M, Mandic Z, Rogosic V et al. Pseudoexfoliation syndrome and asymptomatic myocardial dysfunction. Graefes Arch Clin Exp Ophthalmol 2005; 243 (5): 446–449.
Tarkkanen A, Reunanen A, Kivela T . Frequency of systemic vascular diseases in patients with primary open-angle glaucoma and exfoliation glaucoma. Acta Ophthalmol 2008; 86 (6): 598–602.
Lee KW, Blann AD, Lip GY . Impaired tissue Doppler diastolic function in patients with coronary artery disease: relationship to endothelial damage/dysfunction and platelet activation. Am Heart J 2005; 150: 756–766.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Demir, N., Ulus, T., Yucel, O. et al. Assessment of myocardial ischaemia using tissue Doppler imaging in pseudoexfoliation syndrome. Eye 25, 1177–1180 (2011). https://doi.org/10.1038/eye.2011.145
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/eye.2011.145
Keywords
This article is cited by
-
Peripapillary and macular choroidal vascularity index in patients with clinically unilateral pseudoexfoliation syndrome
Eye (2021)
-
Paraoxonase 1 (PON1) promoter (−107T/C) and coding region (192Q/R and 55L/M) genetic variations in pseudoexfoliation syndrome and pseudoexfoliative glaucoma risk
Graefe's Archive for Clinical and Experimental Ophthalmology (2019)
-
Electroneuromyographic findings in pseudoexfoliation syndrome
International Ophthalmology (2018)
-
Ocular Pseudoexfoliation Syndrome Linkage to Cardiovascular Disease
Current Cardiology Reports (2016)


