TANER ULUS, Kamal ISGANDAROV, Sayyed Hamed MOGHANCHIZADEH, Merve BOZKURT, FEZAN MUTLU, Nilgün YILDIRIM

Psödoeksfoliasyon Sendromlu Hastalarda Atriyal İleti Zamanı

Pseudoeksfoliasyon sendromu (PES) göz ve göz dışı pek çok dokuda anormal hücre dışı fibriler mataryelin birikimi ile karakterize sistemik bir hastalıktır. Pseudoeksfoliasyon sendromu ile kardiyovasküler ve serebrovasküler hastalıklar arasında ciddi ilişkiler bulunmuştur. Atriyal fibrilasyonun (AF) da dahil olduğu kardiyak aritmi riskinin PES hastalarında arttığına dair bazı deliller mevcuttur. Bozulmuş atriyal elektromekanik fonksiyon AF gelişiminde önemli bir rol oynar. Bu çalışma PES hastalarında atriyal elektromekanik gecikme (EMG) sürelerinin değerlendirilmesini amaçlamaktadır. Otuz dört PES hastası ve PES materyeli olmayan 29 yaş ve cinsiyet uyumlu sağlıklı kontrol çalışmaya alındı. Açlık kan örnekleri alındı, transtorasik ekokardiyografi ve atriyal EMG sürelerini belirlemek için doku Doppler inceleme yapıldı. Septal anulusta S dalga hızı, lateral anulusta S dalga hızı, lateral anulusta izovolümetrik kasılma hızı PES olan grupta kontrol grubuna göre daha düşüktü (sırasıyla p=0.010, 0.025 ve 0.014). Doppler ekokardiyografi ölçümleri atriyal elektromekanik bağlama süresi (PA) lateral, septal ve trikuspit’in PES hastalarında kontrollerden daha fazla olduğunu gösterdi (sırasıyla p<0.001, 0.010 ve 0.046). İnteratriyal EMG [39.00 ms (28.00-44.00) vs 28.00 ms (23.50-33.00), p=0.001] ve intra-sol atriyal EMG [17.00 ms (15.00-23.25) vs 11.00 ms (10.00-17.50), p=0.003] PES hastalarında daha fazlaydı.Pseudoeksfoliasyon sendromu uzamış atriyal EMG süreleri ile ilişkilidir. Ayrıca miyokardiyal sistolik hızlar PES hastalarında daha düşüktür.

Anahtar Kelimeler:

Pseudoeksfoliasyon sendromu, atriyal fibrilasyon, atriyal elektromekanik gecikme

Atrial Conduction Time in Patients with Pseudoexfoliation Syndrome

Pseudoexfoliation syndrome (PEX) is a systemic disorder characterized by the accumulation of an abnormal fibrillar material in various ocular and extraocular tissues. Significant associations between PEX and cardiovascular, and cerebrovascular diseases were found. There is some evidence suggesting an increased risk of cardiac arrhythmias including atrial fibrillation (AF) in patients with PEX. Impaired atrial electromechanical function plays a significant role in the development of AF. This study aims to evaluate atrial electromechanical delay (EMD) times in patients with PEX. Thirty-four PEX patients and 29 age-matched and sex-matched healthy controls who had no PEX material were included. Fasting blood samples were taken, transthoracic echocardiography and tissue Doppler imaging were performed to determine atrial EMD times. The S-wave velocity at the septal annulus, the S-wave velocity at the lateral annulus, and the isovolumetric contraction velocity at the lateral annulus were lower in patients with PEX than in controls (p=0.010, 0.025 and 0.014, respectively). Tissue Doppler imaging measurements showed that the atrial electromechanical coupling time (PA) lateral, PA septal, and PA tricuspid were higher in patients with PEX than in controls (p<0.001, 0.010 and 0.046, respectively). Interatrial EMD [39.00 ms (28.00-44.00) vs 28.00 ms (23.50-33.00), p=0.001] and intra-left atrial EMD [17.00 ms (15.00-23.25) vs 11.00 ms (10.00-17.50), p=0.003] were higher in patients with PEX. Pseudoexfoliation syndrome is associated with prolonged atrial EMD times. In addition, myocardial systolic velocities are lower in patients with PEX.

Keywords:

Pseudoexfoliation syndrome, atrial fibrillation, atrial electromechanical delay,

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