Is Autonomic Function Impaired In Patients With Pseudoexfoliation Syndrome?

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 METHODSA 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.