ABSTRACT
There is not enough information about tinnitus and related parameters in patients with heart failure with reduced ejection fraction (HFrEF). In our study, we aimed to investigate the frequency of tinnitus in HFrEF patients and the clinical parameters associated with this condition. This study included 100 patients with HFrEF and whose medical treatment was arranged according to their disease stage, and 100 control patients without HFrEF with similar age, gender and cardiovascular risk factors. Routine history, physical examinations, echocardiography and laboratory examinations were performed. In addition, a detailed ear examination and tinnitus evaluation were performed in all patients. First of all, the frequency of tinnitus in patients with and without HFrEF was determined. Afterwards, all individuals included in the study were divided into two groups as individuals with and without tinnitus. It was determined that the frequency of tinnitus was higher in patients with HFrEF compared to individuals without HFrEF. (25% and 13%, p = 0.023). It was determined that hypertension and hyperlipidemia were more common in the patient group with tinnitus, the patients were older, and the frequency of use of beta blocker, diuretic or spironolactone treatment was higher (p < 0.05 for each). Serum uric acid and NT-proBNP levels were found to be higher in patients with tinnitus (p < 0.05 for each). Logistic regression analysis was performed with the parameters which were found to be significantly different in patients with tinnitus, and in this analysis, age and NT-proBNP levels were found to be independently associated with the presence of tinnitus (p < 0.001 and p = 0.005). According to this analysis, it was determined that every one year increase of age and every 20 pg/mL increase of NTproBNP increased the frequency of tinnitus by 12% and 6.1%, respectively. The frequency of tinnitus increases in patients with HFrEF. Although the increased frequency of tinnitus in these patients is associated with diuretic therapy, increasing age and high NT-proBNP levels are independently associated with the presence of tinnitus in these patients. NT-proBNP may be a follow-up parameter for tinnitus in patients with HFrEF. However, our study needs to be supported by other studies and studies involving more patients.
ABSTRACT
Objectives: Patients with pseudoexfoliation syndrome (PES) can also have sensorineural hearing loss as well as balance problems. Our aim was to evaluate vestibulocochlear system involvement in PES patients. Materials and Methods: The study included 16 subjects with PES (study group) with a mean age of 66.12±5.64 years and 17 healthy subjects (control group) with a mean age of 61.70±8.46 years. Both groups underwent ophthalmological, neuro-otological, audiological, and vestibular evaluation. Pure-tone audiometry and tympanometry were performed as audiological tests and bithermal caloric test and vestibular-evoked myogenic potential (VEMP) testing were used as vestibular tests. The Romberg, tandem Romberg, and Unterberger tests were also performed. Results: In the PES group, bithermal caloric tests revealed right canal paresis in 6 patients, left canal paresis in 3 patients, and bilateral stimulation loss in 2 patients, despite no clinical evidence of balance loss. Paresis was not detected in any of the control subjects. Unilateral VEMP responses could not be obtained in 3 patients in the PES group. The ocular PES patients whose VEMP waves were obtained differed significantly from the control group (p<0.05). In office tests for vestibular evaluation, pathologic findings were found in 7 of 16 patients in the study group and only 4 subjects in the control group. Audiological evaluation with pure-tone thresholds revealed sensorineural decline at 4000 and 8000 Hertz in the PES patients. A statistically significant difference was found between the study group and the control group (p<0.05). Conclusion: Patients with PES showed elevation in pure-tone thresholds and a decrease in superior and inferior vestibular nerve function, demonstrating that the vestibular system as well as the auditory system are affected in PES.
