Systemische Endotheldysfunktion bei Patienten mit Pseudoexfoliationssyndrom

Zusammenfassung

Hintergrund: Das Pseudoexfoliationssyndrom (PEX) ist eine häufige altersbezogene Schädigung der extrazellulären Matrix. Es ist eine systemische Erkrankung, gekennzeichnet durch abnorme fibrilläre Ablagerungen in Strukturen des vorderen Augenabschnitts sowie in Haut, Herz, Leber, Lunge, Hirn, Nieren, Gallenblase und Blutgefäßen. Zweck unserer Studie war es, Anzeichen von gestörter Gefäßeendothelfunktion bei PEX-Patienten festzustellen, im Vergleich zu den Kontrollen entsprechenden Alters und Geschlechts. Patienten/Material und Methoden: Es wurden 21 Patienten mit PEX und 21 Kontrollen entsprechenden Alters und Geschlechts prospektiv untersucht. Aufgrund der Reaktion auf die strömungsvermittelte Gefäßerweiterung (Flow-Mediated Dilation, FMD) und die Nitroglyzerin-induzierte Gefäßerweiterung (Nitroglycerin-Mediated Dilation, NMD) wurde die Endothelfunktion der Brachialarterie mittels Ultraschall mit hoher Auflösung beurteilt. Ergebnisse: Patienten mit PEX hatten eine signifikant niedrigere FMD (1,9 – 2,8 versus 4,1 – 3,3 in der Kontrollgruppe, p = 0,02). Auch die NMD war bei PEX-Patienten niedriger als in der Kontrollgruppe, obwohl der Unterschied nicht statistisch signifikant war (10,1 – 5,1 versus 10,8 – 5,8 in der Kontrollgruppe, p < 0,69). Schlussfolgerungen: Unsere Untersuchung zeigte eine statistisch signifikante Assoziation zwischen PEX und systemischer vaskulärer Endotheldysfunktion. Es sind größere klinische Studien notwendig, um die größere kardiovaskuläre Gefährdung von PEX-Patienten zu beweisen.

Abstract

Background: Recent studies have shown that pseudoexfoliation syndrome (PEX) is not limited to the anterior segment of the eye, but also affects different structures, such as blood vessels, heart, liver and lungs. Vascular endothelial dysfunction is associated with an increased cardiovascular risk. The purpose of our study was to evaluate endothelial function of the brachial artery in patients with PEX. Patients/Materials and Methods: We prospectively examined 21 patients with PEX and 21 age- and sex-matched individuals in a control group. Brachial artery endothelial function was assessed by the response to flow-mediated dilation (FMD) and nitroglycerin-mediated dilation (NMD) using high resolution ultrasound. Dilation was expressed as the percent change in diameter relative to the baseline diameter. Results: Patients with PEX had significantly lower FMD (1.9 – 2.8 versus 4.1 – 3.3 in the control group, p = 0.02). NMD in PEX patients was lower than in the control group (10.1 – 5.1 versus 10.8 – 5.8 in the control group, p < 0.69), but the difference was not statistically significant. Conclusions: Our study showed a statistically significant association between PEX and systemic vascular endothelial dysfunction. Larger clinical studies are needed to prove the higher cardiovascular risk in PEX patients.

Schlüsselwörter

Glaukom - Biochemie - Pathologie

Key words

glaucoma - biochemistry - pathology

Literatur

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