title: Assessment of myocardial ischaemia using tissue Doppler imaging in pseudoexfoliation syndrome.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Ophthalmology, Erzurum Regional Education and Research Hospital, The Ministry of Health, Erzurum, Turkey. drnihaldemir@yahoo.com
authors.forename: N
authors.initials: N
authors.lastname: Demir
authors.forename: T
authors.initials: T
authors.lastname: Ulus
authors.forename: O E
authors.initials: OE
authors.lastname: Yucel
authors.forename: E T
authors.initials: ET
authors.lastname: Kumral
authors.forename: E
authors.initials: E
authors.lastname: Singar
authors.forename: H I
authors.initials: HI
authors.lastname: Tanboga
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D015150:Echocardiography, Doppler; D017889:Exfoliation Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013599:Systole / Q000502:physiology