Turkiye Klinikleri Journal of Dermatology

.: ORIGINAL RESEARCH
Subclinical Left Ventricular Dysfunction in Patients with Psoriasis Assessed Using Speckle Tracking Echocardiography
Psöriyazis Hastalarında Subklinik Sol Ventriküler Disfonksiyonun Speckle Tracking Ekokardiyografi ile Değerlendirilmesi
Ezgi AKTAŞ KARABAYa, Aslı AKSU ÇERMANb, Damla DEMİRc, İlknur KIVANÇ ALTUNAYb, Mutlu ÇAĞAN SÜMERKANd
a Department of Skin and Venereal Diseases, Bahçeşehir University Medical Park Göztepe Hospital,
Clinics of
b Skin and Venereal Diseases,
d Cardiology,
İstanbul University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital,
c Department of Dermatology and Venereology, Ümraniye Training and Research Hospital,
İstanbul, TURKEY
Turkiye Klinikleri J Dermatol. 2019;29(2):51-7
doi: 10.5336/dermato.2019-70951
Article Language: EN
Full Text
ABSTRACT
 Objective: Psoriasis, which is a chronic inflammatory disease is associated with an increased risk of cardiovascular (CV) diseases (CVD). Currently, no method is available to evaluate subclinical CV dysfunction in patients with psoriasis. The aim of the study was to evaluate left ventricular (LV) function in patients with untreated psoriasis but no risk factors for CV disease (CVD). Material and Methods: Thirty patients with psoriasis without any CVD or risk factors for CVD and 20 age- and gender-matched controls were recruited. All patients underwent detailed transthoracic echocardiography, including speckle tracking-derived strain analysis. Results: Speckle tracking echocardiography showed significantly lower global circumferential strain in psoriatic patients compared to healthy controls (mean ±SD: -23.34±6.74% vs. -27.53±4.11%, respectively, p<0.001). No significant differences were found in terms of global longitudinal strain, aortic flow velocity, pulmonary arterial flow velocity, LV end-systolic volume, LV end-diastolic volume, LV ejection fraction, peak of early diastolic (E) and late diastolic (A) flow velocity, E⁄A ratio, and levels of biochemical markers, including C-reactive protein, between the patients and controls (p>0.05). Conclusion: Subclinical myocardial dysfunction was seen in the patients with psoriasis who had no conventional risk factors for CVD using two-dimensional strain imaging. We believe that this imaging technique may be useful for early detection of CVD development in patients with psoriasis.

Keywords: Cardiovascular diseases; psoriasis; two-dimensional strain imaging
ÖZET
 Amaç: Kronik, inflamatuar bir hastalık olan psöriyazis artmış kardiyovasküler (KV) hastalık (KVH) riski ile ilişkilidir. Şu anda, psöriyazis hastalarında subklinik KV disfonksiyonu inceleyen bir yöntem bulunmamaktadır. Bu çalışmanın amacı, tedavi almayan ve KVH gelişimi açısından hiçbir risk faktörü bulunmayan psöriyazisli hastalarda sol ventrikül fonksiyonunu incelemektir. Gereç ve Yöntemler: Bilinen KVH öyküsü veya KVH gelişimi için hiçbir risk faktörü bulunmayan 30 psöriyazis hastası ve yaş ve cinsiyet açısından uyumlu 20 sağlıklı kontrol çalışmaya dahil edildi. Tüm hastalara speckle traking derivasyonlar da dahil olmak üzere detaylı transtorasik ekokardiyografi yapıldı. Bulgular: Speckle traking ekokardiyografi ile global sirkümferensiyal gerilme, psöriyazis hastalarında kontrollere göre belirgin olarak daha düşük saptandı (ortalama ±SS: -23,34±%6,74 vs.-27,53±%4,11, sırasıyla, p<0,001). Global longitudinal gerilme, aort akım hızı, pulmoner arter akım hızı, sol ventrikül sistolsonu hacmi, sol ventrikül ejeksiyon fraksiyonu, erken diyastolik akım hızı (E) ve geç diyastolik (A) akım hızı tepe noktası sistol sonu volüm, E⁄A oranı ve C-reaktif protein de dahil olmak üzere biyokimyasal parametreler açısından psöriyazis hastaları ve kontrol grubu arasında anlamlı fark saptanmadı (p>0,05). Sonuç: Kardiyovasküler hastalık gelişimi açısından geleneksel risk faktörü bulunmayan psöriyazis hastalarında iki-boyutlu gerilme görüntüleme kullanılarak subklinik myokard disfonksiyonu saptandı. Bu görüntüleme tekniğinin psöriyazis hastalarında KVH gelişimini erken dönemde belirlemek açısından faydalı olabileceğini düşünmekteyiz.

Anahtar Kelimeler: Kardiyovasküler hastalık; psöriyazis; iki boyutlu gerilme görüntüleme
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