Department of Cardiology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.
Department of Cardiology, Training and Research Hospital, Uşak University, Uşak, Turkey.
Echocardiography. 2021 Apr;38(4):604-611. doi: 10.1111/echo.15031. Epub 2021 Mar 18.
Pseudoexfoliation syndrome (PEX) is a disease characterized by the accumulation of fibrillary material in the extracellular matrix in the eye and many tissues. Myocardial involvement occurs as in other storage diseases. Speckle tracking echocardiography is a quantitative echocardiography modality that enables the detection of subclinical changes that cannot be detected by standard echocardiographic evaluation. In this study, we aimed to evaluate potential subclinical myocardial dysfunction in PEX patients by speckle tracking echocardiography.
The study group consisting of 29 cardiac asymptomatic pseudoexfoliation syndromes and 30 healthy volunteers were included in this case-control cross-sectional study. Detailed echocardiographic evaluations and strain analyses of all participants were performed. Concerning standard echocardiographic parameters, there was only a marginally significant difference between the two groups in the e' mean wave, and it was lower in the PEX group than the control group (0.07 ± 0.03, 0.10 ± 0.08, respectively, P = .06). However, in strain echocardiography, the global longitudinal strain (GLS) value was observed to be significantly lower in the PEX group than the control group (-17.02 ± 2.02, -19.29 ± 2.26, respectively P < .001). GLS was observed to be an independent predictor in the multivariable logistic regression model made to determine independent predictors of PEX syndrome (OR = 0.59, CI = 0.418-0.832, P = .003).
Subclinical myocardial involvement in PEX syndrome, in which standard echocardiographic techniques are blinded, can be detected by the strain echocardiography. PEX causes deterioration in the deformation parameters of the left ventricle. Systemic involvement should not be forgotten in patients with PEX and cardiac functions should be monitored.
假性剥脱综合征（PEX）是一种以眼和许多组织细胞外基质中纤维状物质积累为特征的疾病。心肌受累与其他贮积病相似。斑点追踪超声心动图是一种定量超声心动图方法，能够检测到标准超声心动图评估无法检测到的亚临床变化。在这项研究中，我们旨在通过斑点追踪超声心动图评估 PEX 患者潜在的亚临床心肌功能障碍。
这项病例对照横断面研究纳入了 29 例心脏无症状假性剥脱综合征患者和 30 名健康志愿者作为研究组。对所有参与者进行了详细的超声心动图评估和应变分析。关于标准超声心动图参数，两组间 e'平均波只有轻微的差异，且 PEX 组低于对照组（分别为 0.07±0.03 和 0.10±0.08，P=0.06）。然而，在应变超声心动图中，PEX 组的整体纵向应变（GLS）值明显低于对照组（分别为-17.02±2.02 和-19.29±2.26，P<0.001）。在确定 PEX 综合征的独立预测因子的多变量逻辑回归模型中，GLS 被观察到是一个独立的预测因子（OR=0.59，CI=0.418-0.832，P=0.003）。
在标准超声心动图技术无法发现的 PEX 综合征中，可以通过应变超声心动图检测到亚临床心肌受累。PEX 导致左心室变形参数恶化。在 PEX 患者中，不应忘记全身受累，应监测心功能。
