Increase of carotid artery stiffness and decrease of baroreflex sensitivity in exfoliation syndrome and glaucoma.
OBJECTIVE
To investigate the distensibility of the common carotid artery (CCA), baroreflex sensitivity (BRS) and its relation to plasma homocysteine concentration in exfoliation syndrome or exfoliation glaucoma (XFS/XFG).


METHODS
Homocysteine concentrations were measured in 30 XFS/XFG patients and 18 age matched controls. In 21 patients and 17 controls the end diastolic diameter of the CCA and pulsatile distension were measured and BRS was calculated.


RESULTS
There was no significant difference between the groups in sex distribution, age, heart rate, blood pressure, systemic diseases, or medication. In XFS/XFG patients homocysteine concentration was significantly elevated (unpaired t test, p = 0.023), and CCA stiffness was higher (p<0.05), while strain, cross sectional compliance coefficient, distensibility, and BRS were significantly reduced compared to the controls (Mann-Whitney U test, p< or =0.013 for each parameter). In XFS/XFG patients a positive correlation was found between age and plasma homocysteine level (Pearson's correlation, r = 0.490, p = 0.007), and a negative correlation between age and BRS (Kendall's correlation r = -0.374, p = 0.021), as well as between homocysteine concentration and BRS (Kendall's correlation r = -0.377, p = 0.024). No correlation was seen between these variables in the control group.


CONCLUSIONS
These results suggest a pathological large artery function as well as altered parasympathetic vascular control in XFS/XFG which increases with age and with higher homocysteine concentration.
Department of Ophthalmology, Semmelweis University, Budapest, Hungary. hg@szem1.sote.hu
Z
Z
Visontai
B
B
Merisch
M
M
Kollai
G
G
Holló
D000368:Aged; D000369:Aged, 80 and over; D017704:Baroreflex; D001794:Blood Pressure; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004548:Elasticity; D004562:Electrocardiography; D017889:Exfoliation Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011674:Pulse; D017539:Tunica Intima / Q000000981:diagnostic imaging; D014463:Ultrasonography