title: 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 (BNP) 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 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Mersin University; Mersin-Turkey. drdilekcicek@hotmail.com.
authors.forename: Dilek
authors.initials: D
authors.lastname: Ciçek Yılmaz
authors.forename: Ayça
authors.initials: A
authors.lastname: Yılmaz
authors.forename: Idil
authors.initials: I
authors.lastname: Göksel
authors.forename: Abdullah
authors.initials: A
authors.lastname: Cirit
authors.forename: Fikret
authors.initials: F
authors.lastname: Sen
authors.forename: Lülüfer
authors.initials: L
authors.lastname: Tamer
mesh_terms: D015415:Biomarkers / Q000097:blood*; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D017889:Exfoliation Syndrome / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain