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