Yıl: 2020 Cilt: 5 Sayı: 3 Sayfa Aralığı: 200 - 204 Metin Dili: İngilizce DOI: 10.5152/cjms.2020.1330 İndeks Tarihi: 08-06-2021

Is Autonomic Function Impaired in Patients with Pseudoexfoliation Syndrome?

Öz:
BACKGROUND/AIMSPseudoexfoliative syndrome is an aging disease that progresses primarily with the accumulation of fibrillary materials in the eye and in some organs other than the eye, particularly in the heart. Accumulation of this substance in the heart is closely related to morbidity and mortality. This study aimed to evaluate the heart rate recovery index (HRR-I), which is a predictor of autonomic dysfunction. MATERIAL and METHODS A total of 253 patients diagnosed with PEX in the ophthalmology outpatient clinic between March 2018 and May 2019 were included in the study. The control group consisted of 238 participants who were diagnosed as non-PEX and had no disease. After routine physical and blood examinations, both groups underwent routine electrocardiograms, transthoracic echocardiograms, and treadmill exercise test (TET). Heart rates of the study and control groups were recorded at the beginning, peak exercise, first, second, and third recovery levels of TET. Heart rate recovery index (HRR-I) values of the first, second, and third minutes were subtracted from the peak level HR values and compared. RESULTSIn the study group, first-minute HRR-I value (20.93±5.93 ms vs. 32.11±5.43 ms, t=21.74 and p<0.01), second-minute HRR-I value (38.83±6.99 ms vs. 51.65±7.12 ms, t=20.12 and p<0.01), and third-minute HRR-I value (62.76±9.56 ms vs. 77.21±12.22 ms, t=14.64 and p<0.01) were found to be lower than in the other group. CONCLUSIONThere were significantly lower HRR-I values at every recovery stage of the TET. These findings revealed that the autonomic balance is impaired in patients with PEX and that the risk of sudden cardiac death increases.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Wang W, He M, Zhou M, Xiulan Z. Ocular Pseudoexfoliation Syndrome and Vascular Disease: A Systematic Review and Meta-Analysis. PLo S One 2014; 9(3): e92767. [Crossref]
  • 2. Gonen KA, Gonen T, Gumus B. Reply: Pseudoexfoliation syndrome and cardiovascular disease: studies must control for all cardiovascular risk factors. Eye 2013; 27(11): 1329. [Crossref]
  • 3. Mitchell P, Wang JJ, Smith W. Association of pseudoexfoliation syndrome with increased vascular risk. Am J Ophthalmol 1997; 124(5): 685-7. [Crossref]
  • 4. Citirik M, Acaroglu G, Batman C, Yildiran L, Zilelioglu O. A possible link between the pseudoexfoliation syndrome and coronary artery disease. Eye (Lond) 2007; 21(1): 11-5. [Crossref]
  • 5. Andrikopoulos GK, Mela EK, Georgakopoulos CD, Papadopoulos GE, Damelou AN, Alexopoulos DK, et al. Pseudoexfoliation syndrome prevalence in Greek patients with cataract and its association to glaucoma and coronary artery disease. Eye (Lond) 2009; 23(2): 442-7. [Crossref]
  • 6. Vivekananthan DP, Blackstone EH, Pothier CE, Lauer MS. Heart rate recovery after exercise is a predictor of mortality, independent of the angiographic severity of the coronary disease. J Am Coll Cardiol 2003; 42(5): 831-8. [Crossref]
  • 7. Morshedi-Meibodi A, Larson MG, Levy D, O'Donnell CJ, Vasan RS. Heart rate recovery after treadmill exercise testing and risk of cardiovascular disease events (The Framingham Heart Study). Am J Cardiol 2002; 90(8): 848-52. [Crossref]
  • 8. Cole CR, Blackstone EH, Pashkow FJ, Snader CE, Lauer MS. Heart-rate recovery immediately after exercise as a predictor of mortality. N Engl J Med 1999; 341(18): 1351-7. [Crossref]
  • 9. Lauer MS, Okin PM, Larson MG, Evans JC, Levy D. Impaired heart rate response to graded exercise. Prognostic implications of chronotropic incompetence in the Framingham Heart Study. Circulation 1996; 93(8): 1520-6. [Crossref]
  • 10. Shetler K, Marcus R, Froelicher VF, Vora S, Kalisetti D, Prakash M, et al. Heart rate recovery: validation and methodologic issues. J Am Coll Cardiol 2001; 38(7): 1980-7. [Crossref]
  • 11. Okutucu S, Karakulak UN, Aytemir K, Oto A. Heart rate recovery: a practical clinical indicator of abnormal cardiac autonomic function. Expert Rev Cardiovasc Ther 2011; 9(11): 1417-30. [Crossref]
  • 12. Ardıç I, Kaya MG, Yarlıoglues M, Doğdu O, Büyükoğlan H, Kalay N, et al. Impaired heart rate recovery index in patients with sarcoidosis. Chest 2011; 139(1): 60-8. [Crossref]
  • 13. San Antonio R, Guasch E, Tolosana JM, Lluís M. Determining the best approach to reduce the impact of exercise-induced atrial fibrillation: prevention, screening, or symptom-based treatment? Expert Rev Cardiovasc Ther 2018; 17(1): 19-29. [Crossref]
  • 14. Kling F, Colin J. Potential association of pseudoexfoliation syndrome (PEX) with age-related macular degeneration (ARMD). J Fr Ophthalmol 2001; 24(1): 7-12.
  • 15. Sumeet S. Chugh, Joseph B. Weiss. Sudden Cardiac Death in the Older Athlete. J Am Coll Cardiol 2015; 65(5): 493-502. [Crossref]
  • 16. Brajkovic J, Surac IK, Ercegovic A, Miletić-Jurić A, Sušić N, Burić Z. Ocular Pseudoexfoliation syndrome and internal systemic diseases. Acta Clin Croat 2007; 46(suppl 1): 57-61.
  • 17. Bruce RA. Exercise testing of patients with coronary heart disease. Principles and normal standards for evaluation. Ann Clin Res 1971; 3(6): 323-32.
  • 18. Jae SY, Bunsawat K, Kunutsor SK, Eun Sun Yoon, Hyun Jeong Kim, Mira Kang, et al. Relation of Exercise Heart Rate Recovery to Predict Cardiometabolic Syndrome in Men. Am J Cardiol 2018: 123(4): 582-7. [Crossref]
  • 19. Campuzano O, Sanchez-Molero O, Fernandez A, Mademont-Soler I, Coll M, Perez-Serra A, et al. Sudden Arrhythmic Death During Exercise: A Post-Mortem Genetic Analysis. Sports Med 2017; 47(10): 2101-15. [Crossref]
  • 20. Zhou S, Jung BC, Tan AY, Vinh QT, Ghassan G, Seong-WH, et al. Spontaneous stellate ganglion nerve activity and ventricular arrhythmia in a canine model of sudden death. Heart Rhythm 2008; 5(1): 131 -9. [Crossref]
  • 21. Nederend I, Schutte NM, Bartels M, Arend DJ Ten Harkel, Eco JC de Geus. Heritability of heart rate recovery and vagal rebound after exercise. Eur J Appl Physiol 2016; 116(11-12): 2167-76. [Crossref]
  • 22. Bleich S, Roedl J, Von Ahsen N, Ursula S-S, Udo R, Georg B, et al. Elevated homocysteine levels in aqueous humor of patients with pseudoexfoliation glaucoma. Am J Ophthalmol 2004; 138(1): 162-4. [Crossref]
  • 23. Roedl JB, Bleich S, Reulbach U, Robert R, Johannes K, Friedrich EK, et al. Homocysteine in tear fluid of patients with pseudoexfoliation glaucoma. J Glaucoma 2007; 16(2): 234-9. [Crossref]
  • 24. Roedl JB, Bleich S, Reulbach U, Rejdak R, Naumann GOH, Kruse FE, et al. Vitamin deficiency and hyperhomocysteinemia in pseudoexfoliation glaucoma. J Neural Transm 2007; 114(5): 571-5. [Crossref]
  • 25. Ercegoviæ A, Brajkoviæ J, Suraæ IK, Marijana BH. Prevalence, distribution, and types of corneal astigmatism in cataract surgery patients in Sibenik Country. Acta Clin Croat 2012; 51(2): 275-8.
  • 26. Hollo G, Lakatos P, Farkas K. Cold pressor test and plasma endothelin-1 concentration in primary open-angle and capsular glaucoma. J Glaucoma 1998; 7(2): 105-10. [Crossref]
  • 27. Visontai Z, Merisch B, Kollai M, Gábor H. Increase in carotid artery stiffness and decrease of baroreflex sensitivity in exfoliation syndrome and glaucoma. Br J Ophthalmol 2006; 90(5): 563-7. [Crossref]
  • 28. Visontai Z, Horváth T, Kollai M, Gábor H. Decreased cardiovagal regulation in exfoliation syndrome. J Glaucoma 2008; 17(2): 133-8. [Crossref]
  • 29. Peçanha T, Silva-Júnior ND, Forjaz CL. Heart rate recovery: autonomic determinants, methods of assessment and association with mortality and cardiovascular diseases. Clin Physiol Funct Imaging 2014; 34(5): 327-39. [Crossref]
  • 30. Lauer M, Froelicher ES, Williams M, Kligfield P, American Heart Association Council on Clinical Cardiology SoECR, Prevention. Exercise testing in asymptomatic adults: a statement for professionals from the American Heart Association Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention. Circulation 2005; 112(5): 771-6. [Crossref]
  • 31. Sears CE, Choate JK, Paterson DJ. Inhibition of nitric oxide synthase slows heart rate recovery from cholinergic activation. J Appl Physiol (1985) 1998; 84(5): 1596-603. [Crossref]
  • 32. Vivekananthan DP, Blackstone EH, Pothier CE, Lauer MS. Heart rate recovery after exercise is a predictor of mortality, independent of the angiographic severity of the coronary disease. J Am Coll Cardiol 2003; 42(5): 831-8. [Crossref]
  • 33. Morshedi-Meibodi A, Larson MG, Levy D, O'Donnell CJ, Vasan RS. Heart rate recovery after treadmill exercise testing and risk of cardiovascular disease events (The Framingham Heart Study) Am J Cardiol 2002; 90(8): 848-52. [Crossref]
  • 34. Panzer C, Lauer MS, Brieke A, Blackstone E, Hoogwerf B. Association of fasting plasma glucose with heart rate recovery in healthy adults: a population-based study. Diabetes 2002; 51(3): 803-7. [Crossref]
  • 35. Jouven X, Empana JP, Schwartz PJ, Desnos M, Courbon D, Ducimetiere P. Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med 2005; 352(19): 1951-8. [Crossref]
APA cosgun a, Güneş A (2020). Is Autonomic Function Impaired in Patients with Pseudoexfoliation Syndrome?. , 200 - 204. 10.5152/cjms.2020.1330
Chicago cosgun ayhan,Güneş Alper Is Autonomic Function Impaired in Patients with Pseudoexfoliation Syndrome?. (2020): 200 - 204. 10.5152/cjms.2020.1330
MLA cosgun ayhan,Güneş Alper Is Autonomic Function Impaired in Patients with Pseudoexfoliation Syndrome?. , 2020, ss.200 - 204. 10.5152/cjms.2020.1330
AMA cosgun a,Güneş A Is Autonomic Function Impaired in Patients with Pseudoexfoliation Syndrome?. . 2020; 200 - 204. 10.5152/cjms.2020.1330
Vancouver cosgun a,Güneş A Is Autonomic Function Impaired in Patients with Pseudoexfoliation Syndrome?. . 2020; 200 - 204. 10.5152/cjms.2020.1330
IEEE cosgun a,Güneş A "Is Autonomic Function Impaired in Patients with Pseudoexfoliation Syndrome?." , ss.200 - 204, 2020. 10.5152/cjms.2020.1330
ISNAD cosgun, ayhan - Güneş, Alper. "Is Autonomic Function Impaired in Patients with Pseudoexfoliation Syndrome?". (2020), 200-204. https://doi.org/10.5152/cjms.2020.1330
APA cosgun a, Güneş A (2020). Is Autonomic Function Impaired in Patients with Pseudoexfoliation Syndrome?. Cyprus Journal of Medical Sciences, 5(3), 200 - 204. 10.5152/cjms.2020.1330
Chicago cosgun ayhan,Güneş Alper Is Autonomic Function Impaired in Patients with Pseudoexfoliation Syndrome?. Cyprus Journal of Medical Sciences 5, no.3 (2020): 200 - 204. 10.5152/cjms.2020.1330
MLA cosgun ayhan,Güneş Alper Is Autonomic Function Impaired in Patients with Pseudoexfoliation Syndrome?. Cyprus Journal of Medical Sciences, vol.5, no.3, 2020, ss.200 - 204. 10.5152/cjms.2020.1330
AMA cosgun a,Güneş A Is Autonomic Function Impaired in Patients with Pseudoexfoliation Syndrome?. Cyprus Journal of Medical Sciences. 2020; 5(3): 200 - 204. 10.5152/cjms.2020.1330
Vancouver cosgun a,Güneş A Is Autonomic Function Impaired in Patients with Pseudoexfoliation Syndrome?. Cyprus Journal of Medical Sciences. 2020; 5(3): 200 - 204. 10.5152/cjms.2020.1330
IEEE cosgun a,Güneş A "Is Autonomic Function Impaired in Patients with Pseudoexfoliation Syndrome?." Cyprus Journal of Medical Sciences, 5, ss.200 - 204, 2020. 10.5152/cjms.2020.1330
ISNAD cosgun, ayhan - Güneş, Alper. "Is Autonomic Function Impaired in Patients with Pseudoexfoliation Syndrome?". Cyprus Journal of Medical Sciences 5/3 (2020), 200-204. https://doi.org/10.5152/cjms.2020.1330