| Abstract
| - Objectives. Psoriatic Arthritis (PsA) is a chronic inflammatory disorder. Its etiology is unknown and it is associated with psoriasis. Endothelial dysfunction and early atherosclerosis have been found a high prevalence in PsA patients. Few studies have investigated whether there is any early impairment of myocardial function. Conventional echocardiography parameters have limited sensitivity to detect subtle myocardial dysfunction in patients with PsA. The aim of this study was to assess, by using the novel technique, the presence of myocardial dysfunction in patients with PsA. Methods. 31 PsA patients without clinical evidence of CVD and 19 matched (age, gender, body mass index, smoking status) healthy control subjects were enrolled. All were undergone by conventional echocardiography, tissue Doppler imaging and speckle-tracking strain analysis. Results. Eight-teen (58%) patients with PsA had evidence of left diastolic ventricular (LV) dysfunction as defined by septal E’<8 cm/s, and/or septal E/E’>15. Thirteen patients (42%) had evidence of subclinical LH hypertrophy. However, all PsA patients had normal left ventricular ejection fraction. In this study, normal value was defined as >55%. Global longitudinal strains (−17.2 ± 2.7% versus −19.3±2%; P< 0.05), circumferential strains (−14.23 ± 3.0% versus −20.3 ± 4.7%; P = 0.0001), and radial strains (29.8 ± 9. 6% versus 46.5 ± 17%; P =0.001) had been impaired in patients with PsA, as compared with controls. Decreased global longitudinal, circumferential and radialstrains were not associated with disease duration, disease pattern and subjects on disease-modifying antirheumatic drugs (DMARDs) or on tumor necrosis factor(TNF)-α in patients with PsA. Conclusions. PsA patients without established CVD have a high prevalence of subclinical LV dysfunction. Speckle-tracking strain analysis can detect subtle myocardial dysfunction in patients with PsA. The use of this novel imaging technique may therefore improve risk stratification and monitoring of the cardiovascular involvement in patients with PsA. References. - Gladman DD. Psoriatic arthritis. In: Maddison PJ, Isenberg DA, Woo P, Glass DN, Breedveld F, eds. Oxford textbook of rheumatology. 3rd ed. Oxford: Oxford University Press, 2004:766-78. - Eder L, Jayakar J, Shanmugarajah S, Thavaneswaran A, Pereira D, Chandran V, Rosen CF, Gladman DD. The burden of carotid artery plaques is higher in patients with psoriatic arthritis compared with those with psoriasis alone. Ann Rheum Dis. 2012 Jun 26. - Shang Q, Tam LS, Yip GW, Sanderson JE, Zhang Q, Li EK, Yu CM. High prevalence of subclinical left ventricular dysfunction in patients with psoriatic arthritis. J Rheumatol. 2011 Jul;38(7):1363-70. doi: 10.3899/jrheum.101136. Epub 2011 Apr 1. - Gonzalez-Juanatey C, Amigo-Diaz E, Miranda-Filloy JA, Testa A, Revuelta J, Garcia-Porrua C, Martin J, Llorca J, Gonzalez-Gay MA. Lack of echocardiographic and Doppler abnormalities in psoriatic arthritis patients without clinically evident cardiovascular disease or classic atherosclerosis risk factors. Semin Arthritis Rheum. 2006 Apr;35(5):333-9. Disclosure of Interest. None Declared
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