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Evaluation of left ventricular functions in patients with pseudoexfoliation syndrome using tissue Doppler echocardiography and its association with plasma BNP levels [Anatol J Cardiol]
Anatol J Cardiol. 2014; 14(5): 422-426 | DOI: 10.5152/akd.2014.4878  

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

Dilek Çiçek Yılmaz1, Ayça Yılmaz2, İdil Göksel2, Abdullah Cirit1, Fikret Şen3, Lülüfer Tamer3
1Department of Cardiology, Faculty of Medicine, Mersin University; Mersin-Turkey.
2Department of Ophtalmology, Faculty of Medicine, Mersin University; Mersin-Turkey.
3Department of Biochemistry, Faculty of Medicine, Mersin University; Mersin-Turkey.

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.

Keywords: pseudoexfoliation syndrome, diastolic function, left ventricle, echocardiography, tissue Doppler, BNP


Dilek Çiçek Yılmaz, Ayça Yılmaz, İdil Göksel, Abdullah Cirit, Fikret Şen, Lülüfer Tamer. Evaluation of left ventricular functions in patients with pseudoexfoliation syndrome using tissue Doppler echocardiography and its association with plasma BNP levels. Anatol J Cardiol. 2014; 14(5): 422-426


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