Original Article

Heart and Vessels

, Volume 30, Issue 3, pp 347-354

First online:

Assessment of arterial stiffness and cardiovascular hemodynamics by oscillometric method in psoriasis patients with normal cardiac functions

  • Murat SunbulAffiliated withMarmara University Faculty of Medicine, Department of Cardiology
  • , Dilek SeckinAffiliated withMarmara University Faculty of Medicine, Department of Dermatology
  • , Erdal DurmusAffiliated withMarmara University Faculty of Medicine, Department of Cardiology
  • , Zuleyha OzgenAffiliated withMarmara University Faculty of Medicine, Department of Dermatology
  • , Mehmet BozbayAffiliated withMarmara University Faculty of Medicine, Department of Cardiology
  • , Ayfer BozbayAffiliated withFatih University Faculty of Medicine, Department of Dermatology
  • , Tarik KivrakAffiliated withMarmara University Faculty of Medicine, Department of Cardiology
  • , Mustafa OguzAffiliated withMarmara University Faculty of Medicine, Department of Cardiology
  • , Ibrahim SariAffiliated withMarmara University Faculty of Medicine, Department of Cardiology
    • , Tulin ErgunAffiliated withMarmara University Faculty of Medicine, Department of Dermatology
    • , Mehmet AgirbasliAffiliated withMarmara University Faculty of Medicine, Department of CardiologyMarmara University Education and Research Hospital, Fevzi Cakmak Mahallesi Email author 

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Abstract

Arterial stiffness is associated with increased cardiovascular risk. Pulse wave velocity (PWV) and augmentation index (AIx) are non-invasive markers for assessment of arterial stiffness. Increased arterial stiffness is associated with atherosclerosis in patients with psoriasis. Previous studies have shown that high neutrophil-to-lymphocyte ratio (NLR) predicts poor cardiovascular outcome. The aim of this study was to evaluate arterial stiffness and cardiovascular hemodynamics by oscillometric method in psoriasis patients with normal cardiac functions. Fifty consecutive patients with the diagnosis of psoriasis and 50 controls were included in the study. NLR was calculated as the ratio of neutrophil count to lymphocyte count. All patients underwent echocardiographic examination. Measurements of arterial stiffness were carried out using a Mobil-O-Graph arteriograph system. Fifty patients with psoriasis (26 male, mean age 43.3 ± 13.2 years) and 50 controls (33 male, mean age 45.0 ± 6.1 years) were included into the study. The distribution of cardiovascular risk factors was similar between the two groups, and NLR was significantly higher in patients with psoriasis (2.74 ± 1.78 versus 1.82 ± 0.52, p = 0.002). There was a weak correlation between NLR and PASI score without reaching statistical significance (r = 0.300, p = 0.060). While echocardiographic and hemodynamic parameters were comparable between psoriasis and control groups, heart rate was significantly higher in psoriasis group (81.5 ± 15.1 and 75.2 ± 11.8 beats/min, p = 0.021). Psoriasis patients had significantly higher AIx and PWV values as compared to controls (25.8 ± 13.1 versus 17.4 ± 12.3 %, p = 0.001 and 6.78 ± 1.42 versus 6.18 ± 0.80 m/s, p = 0.011, respectively). AI and PWV were significantly associated with psoriasis when adjusted by heart rate (p = 0.005, odds ratio 1.04, 95 % confidence interval 1.01–1.08 and p = 0.035, odds ratio 1.52, 95 % confidence interval 1.02–2.26, respectively). PWV significantly correlated with blood pressure, lipid levels, and several echocardiographic indices. AIx only correlated with left atrial diameter (r = 291, p = 0.040). Linear regression analysis was performed to find predictors of PWV. Central systolic blood pressure, left atrial diameter, and total cholesterol were independent predictors of PWV. PWV and AIx were significantly higher in patients with psoriasis. Assessment of arterial stiffness parameters may be useful for early detection of cardiovascular deterioration in psoriasis patients with normal cardiac functions. Novel inflammatory biomarkers such as NLR may elucidate the mechanism of vascular dysfunction in such patients.

Keywords

Arterial stiffness Pulse wave velocity Augmentation index Psoriasis Cardiovascular risk Neutrophil-to-lymphocyte ratio