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Published on: April 27, 2019
Echocardiographic evaluation of diastolic dysfunction in young and healthy patients with psoriasis: A case-control
Elio Gorga1, Marta Scodro, Francesca Valentini
1University of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health. elio.gorga@gmail.it.
Insights
Psoriasis patients often have preclinical cardiac dysfunction, specifically diastolic dysfunction and increased mitral regurgitation, even without traditional cardiovascular risk factors. Early detection in psoriasis can improve heart health outcomes.
Area of Science:
- Cardiology
- Dermatology
- Systemic Inflammatory Diseases
Background:
- Psoriasis is a prevalent systemic inflammatory disease.
- Inappropriate immune activation in psoriasis is linked to cardiovascular risk.
- Previous studies suggest higher cardiovascular disorder incidence and echocardiographic abnormalities in psoriatic patients.
Purpose of the Study:
- To evaluate preclinical cardiac dysfunction in psoriasis patients without cardiovascular risk factors.
- To compare echocardiographic findings between psoriasis patients and a healthy control group.
Main Methods:
- A cohort of 52 chronic plaque psoriasis patients was compared to a control group.
- Conventional echocardiography and tissue Doppler imaging (TDI) were performed on all participants.
- Analysis focused on left and right ventricular function, dimensions, mass, and mitral regurgitation.
Main Results:
- Left ventricular dimensions, mass, and systolic function were normal in psoriasis patients.
- Left ventricular diastolic dysfunction was observed in 36.5% of psoriasis patients versus 0% in controls.
- Psoriasis patients showed a reduced E/A ratio in the right ventricle and significantly increased mitral regurgitation.
Conclusions:
- Psoriasis patients exhibit preclinical cardiac dysfunction, particularly diastolic dysfunction and mitral regurgitation, independent of traditional risk factors.
- Early echocardiographic screening in psoriasis patients is crucial for timely intervention.
- Identifying and treating subclinical cardiac issues may improve the cardiovascular prognosis of psoriasis patients.
Abstract:
Psoriasis is a systemic inflammatory disease with a great prevalence in general population. The inappropriate activation of the cellular immune system has been hypothesized to be an independent cardiovascular risk factor, given the higher incidence of cardiovascular disorders in psoriatic patients. Echocardiographic abnormalities have been demonstrated too: the aim of our study was to evaluate the presence of preclinical cardiac dysfunction in a cohort of psoriatic patients without cardiovascular risk factors. We enrolled 52 patients with the diagnosis of chronic plaque psoriasis, compared with a control group not affected by any relevant systemic diseases and inflammatory disorders. In all patients and control group, echocardiographic conventional and tissue Doppler (TDI) studies were conducted. The analysis of echocardiographic parameters revealed normal dimension, mass and systolic function of the left ventricle. Left ventricular diastolic dysfunction was found in 36.5% patients in the psoriasis group versus 0% in control group, and significant reduction of the E/A ratio was found also for the right ventricle. A significant increase of mitral regurgitation has been found in psoriatic patients (p=0.005). The early recognition of cardiovascular pre-clinic disease in psoriatic patients may guide a strict follow up and an early treatment, potentially improving cardiovascular prognosis.
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