Assessment of Left Ventricular, Right Ventricular, and Left Atrial Functions Using Strain Echocardiography in Patients With Pseudoexfoliation Syndrome

Pseudoexfoliation (PEX) syndrome is a systemic disorder characterized by abnormal fibrillar material production in the extracellular matrix and its progressive accumulation in various organs, including ocular tissues and the myocardium. Strain echocardiography studies have shown that PEX may cause subclinical myocardial dysfunction; however, its effects on right ventricular (RV) function and left atrial (LA) dynamics remain unexplored. This study aimed to assess potential subclinical right and left ventricular (LV) dysfunction, along with alterations in LA function, in patients with PEX by means of strain echocardiography. This cross-sectional case-control study included 27 asymptomatic patients with PEX without known cardiac disease and 27 healthy volunteers as the control group. All participants underwent comprehensive echocardiographic examinations, including LV, RV, and LA strain (LAS) analyses. Among standard echocardiographic parameters, there were significant differences between the two groups in terms of mean e' (p = 0.001) and deceleration time (DT) (p = 0.001). No significant difference was observed in global longitudinal strain (GLS) values between the PEX and control groups (p = 0.505). Similarly, no significant differences were found in right ventricular free-wall longitudinal strain (RVFWSL) and right ventricular four-chamber strain (RV4CSL) values. In the evaluation of LAS parameters (LASr, LAScd, LASct), a statistically significant difference was detected in LA reservoir strain between the PEX and control groups (p = 0.001). PEX is associated with impairment of LA deformation parameters. Therefore, systemic involvement should be considered in patients with PEX, and these patients should be monitored for cardiac dysfunction and arrhythmias.