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Increase of carotid artery stiffness and decrease of baroreflex sensitivity in exfoliation syndrome and glaucoma
  1. Z Visontai1,
  2. B Merisch2,
  3. M Kollai2,
  4. G Holló1
  1. 1Department of Ophthalmology, Semmelweis University, Budapest, Hungary
  2. 2Institute of Human Physiology and Clinical Experimental Research, Semmelweis University, Budapest, Hungary
  1. Correspondence to: Gábor Holló MD, PhD, DSc, 1083, Budapest, Tömö u 25–29, Hungary; hg{at}szem1.sote.hu

Abstract

Aim: To investigate the distensibility of the common carotid artery (CCA), baroreflex sensitivity (BRS) and its relation to plasma homocysteine concentration in exfoliation syndrome or exfoliation glaucoma (XFS/XFG).

Methods: Homocysteine concentrations were measured in 30 XFS/XFG patients and 18 age matched controls. In 21 patients and 17 controls the end diastolic diameter of the CCA and pulsatile distension were measured and BRS was calculated.

Results: There was no significant difference between the groups in sex distribution, age, heart rate, blood pressure, systemic diseases, or medication. In XFS/XFG patients homocysteine concentration was significantly elevated (unpaired t test, p = 0.023), and CCA stiffness was higher (p<0.05), while strain, cross sectional compliance coefficient, distensibility, and BRS were significantly reduced compared to the controls (Mann-Whitney U test, p⩽0.013 for each parameter). In XFS/XFG patients a positive correlation was found between age and plasma homocysteine level (Pearson’s correlation, r = 0.490, p = 0.007), and a negative correlation between age and BRS (Kendall’s correlation r = −0.374, p = 0.021), as well as between homocysteine concentration and BRS (Kendall’s correlation r = −0.377, p = 0.024). No correlation was seen between these variables in the control group.

Conclusions: These results suggest a pathological large artery function as well as altered parasympathetic vascular control in XFS/XFG which increases with age and with higher homocysteine concentration.

  • BRS, baroreflex sensitivity
  • CC, compliance coefficient
  • CCA, common carotid artery
  • DC, distensibility coefficient
  • MTHFR, 5,10-mehylenetetrahydrofolate reductase
  • WTS, wall track system
  • XFG, exfoliation glaucoma
  • XFS, exfoliation syndrome
  • exfoliation syndrome
  • homocysteine
  • baroreflex sensitivity
  • carotid artery distensibility
  • brachial artery distensibility
  • BRS, baroreflex sensitivity
  • CC, compliance coefficient
  • CCA, common carotid artery
  • DC, distensibility coefficient
  • MTHFR, 5,10-mehylenetetrahydrofolate reductase
  • WTS, wall track system
  • XFG, exfoliation glaucoma
  • XFS, exfoliation syndrome
  • exfoliation syndrome
  • homocysteine
  • baroreflex sensitivity
  • carotid artery distensibility
  • brachial artery distensibility

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Footnotes

  • The study was supported in part by Hungarian National Health Grant (ETT) 011/2003 (GH) and by OTKA Grant T049690 (MK).

  • None of the authors has any interest in any instrument or technique used in the study.

  • Ethics approval (see also Methods section): the research protocol was approved by the Institutional Review Board for Human Research of Semmelweis University, and informed consent was obtained from all participants before imaging was performed.

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