1Cardiologist,Atherosclerosis Prevention Research Center, Cardiovascular department ,Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2Pediatric Resident, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3Dermatologist, Cutaneous Leishmaniasis Research Center, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
4Dermatologist,Cutaneous Leishmaniosis Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
5Medical Student ,Cardiovascular Research Center, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
6Medical Student ,Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
7Cardiologist, Cardiology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Introduction: Psoriasis is a chronic inflammatory skin disease characterized by plaques covered with silvery scales. Psoriasis is highly prevalent in different countries in the world, including Iran. Several studies have reported a significant association between psoriasis and cardiovascular diseases. This study aimed to evaluate the relationship between psoriasis and cardiac disease using echocardiography. Materials and Methods: This cross-sectional study was conducted in Imam Reza Hospital of Mashhad, Iran during 2013-2014 on patients with clinical diagnosis of psoriasis confirmed via biopsy. In addition, healthy volunteers homogenous in terms of age and gender were selected as the control group. Echocardiography was performed on patients and control subjects. Size of the left and right ventricles, left ventricle ejection fraction, diastolic function, and pulmonary artery pressure were recorded. In addition, patients were assessed in terms of the presence of valve regurgitation and disease severity. Results: In total, 23 patients with psoriasis and 23 control subjects were enrolled in this study. Mean duration of psoriasis was 7.0±9.1 years (range: 1-25 years), and disease severity ranged between moderate and severe. Left ventricular end-diastolic and systolic diameters were significantly higher in patients with psoriasis (P=0.030 and P=0.016, respectively). Moreover, left ventricular diastolic dysfunction was observed in 14 psoriasis patients (60.8%) and 3 control subjects (13.4%) (P<0.001), all of whom were presented with grade I diastolic dysfunction. No significant difference was observed in the left atrial volume, mid-right-ventricular diameter, and pulmonary artery pressure. If present, valvular regurgitation was reported to be mild, while the prevalence of mild aortic regurgitation was significantly higher in psoriatic patients compared to control subjects (P=0.032). In addition, no statistically significant difference was observed in mitral or tricuspid valve abnormalities. Conclusion: According to the results of this study, patients with psoriasis commonly present with echocardiographic abnormalities, even in the absence of cardiovascular symptoms.
Menter A, Gottlieb A, Feldman SR, Van Voorhees AS, Leonardi CL, Gordon KB, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. 2008; 58:826-50.
Griffiths CE, Barker JN. Pathogenesis and clinical features of psoriasis. Lancet. 2007; 370:263-71.
Parisi R, Symmons DP, Griffiths CE, Ashcroft DM. Global epidemiology of psoriasis: a systematic review of incidence and prevalence. J Invest Dermatol. 2013; 133:377-85.
Pietrzak A, Lecewicz-Toruń B. Activity of serum lipase [EC 184.108.40.206] and the diversity of serum lipid profile in psoriasis. Med Sci Monit. 2002; 8:CR9-13.
Tekin NS, Tekin IO, Barut F, Sipahi EY. Accumulation of oxidized low-density lipoprotein in psoriatic skin and changes of plasma lipid levels in psoriatic patients. Mediators Inflamm. 2006; 2007:78454.
Gottlieb AB, Chao C, Dann F. Psoriasis comorbidities. J Dermatolog Treat. 2008; 19:5-21.
Patel RV, Shelling ML, Prodanovich S, Federman DG, Kirsner RS. Psoriasis and vascular disease-risk factors and outcomes: a systematic review of the literature. J Gen Intern Med. 2011; 26:1036-49.
Kremers HM, McEvoy MT, Dann FJ, Gabriel SE. Heart disease in psoriasis. J Am Acad Dermatol. 2007; 57:347-54.
Roelandt J. Among the new diagnostic methods in cardiology, echocardiography. Cardiology. 2013; 1:153.
Biyik I, Narin A, Bozok M, Ergene O. Echocardiographic and clinical abnormalities in patients with psoriasis. J Int Med Res. 2006; 34:632-9.
Shang Q, Tam LS, Yip GW, Sanderson JE, Zhang Q, Li EK, et al. High prevalence of subclinical left ventricular dysfunction in patients with psoriatic arthritis. J Rheumatol. 2011; 38:1363-70.