Pseudoexfoliation syndrome and asymptomatic myocardial dysfunction

Background: The purpose of this study was to investigate the frequency of asymptomatic left ventricular dysfunction in patients with pseudoexfoliation syndrome. Methods: Two-dimensional and pulsed Doppler echocardiography of transmitral flow was performed on 27 patients with pseudoexfoliation syndrome, aged 66.9 +/- 5.6 years, and 24 healthy volunteers aged 63.9 +/- 6.5 years. Left ventricular (LV) systolic contraction and ejection were assessed by LV ejection fraction (EF) and fractional shortening (FS). LV diastolic filling parameters tested were: early fast diastolic filling ( E wave), late diastolic filling ( A wave), ratio E/A, velocity time integral E wave (VTIE) and A wave (VTIA), their ratio (VTIE/VTIA), pressure at the end of filling (LVEDP) and a pulmonary capillary wedge pressure (PCWP). Results: Systolic parameters EF and FS, diastolic filling parameters such as A, LVEDP and PCWP were not significantly different between patients with pseudoexfoliation syndrome and controls ( P> 0.05). A significant difference ( P< 0.05) was found with regard to the diastolic filling parameters: E ( 61.6 +/- 15.1 vs 83.7 +/- 21.4), ratio E/A (0.8 +/- 0.1 vs 1.1 +/- 0.2), VTIE (8.6 +/- 1.8 vs 9.8 +/- 1.9), VTIA (10.3 +/- 2.4 vs 7.8 +/- 1.6) and ratio VTIA/ VTIE (1.2 +/- 0.2 vs 0.8 +/- 0.2). Conclusion: Our study suggests the possibility of an association between patients with pseudoexfoliation syndrome and a discrete asymptomatic myocardial diastolic dysfunction.