Summary
Background
Left atrial (LA) volume has been identified as a predictor of adverse cardiovascular outcomes, both in the general population and in selected clinical conditions.
The aim of this study was to evaluate the effect of psoriasis on LA volume and mechanical function.
Methods
A total of 40 consecutive normotensive psoriasis patients free of any cardiovascular disease and 39 healthy volunteers were included. All participants underwent comprehensive transthoracic echocardiographic examination. LA volume and mechanical function were evaluated using real-time three-dimensional echocardiography (RT3DE).
Results
There were no significant differences between psoriasis and control groups with regard to conventional echocardiographic parameters. Individuals with psoriasis had a higher incidence of left ventricular diastolic dysfunction (LVDD) than the controls; nine people with psoriasis (23 %) and three control individuals (8 %) had LVDD (p = 0.06). With regard to the parameters obtained from RT3DE, LA maximum, LA minimum, passive stroke volume, and passive emptying fraction were significantly higher; whereas LA active emptying fraction, LA total emptying fraction, LA expansion index, and active stroke volume values were significantly lower in individuals with psoriasis compared with controls. Disease duration and Psoriasis Area of Severity Index (PASI) score correlated with the majority of volume parameters.
Conclusion
Individuals with psoriasis had higher LA phasic volumes and impaired LA mechanical function compared with healthy controls. LA volume and functional analysis with RT3DE may facilitate recognition of subtle LA dysfunction in patients with psoriasis.
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References
Farberand EM, Nall ML. The natural history of psoriasis in 5,600 patients. Dermatologica. 1974;148(1):1–18.
Ahlehoff O, Gislason GH, Charlot M, et al. Psoriasis is associated with clinically significant cardiovascular risk: a Danish nationwide cohort study. J Intern Med. 2011;270(2):147–57.
Gelfand JM, Neimann AL, Shin DB, et al. Risk of myocardial infarction in patients with psoriasis. JAMA. 2006;296(14):1735–41.
Simsek H, Sahin M, Akyol A, et al. Increased risk of atrial and ventricular arrhythmia in long-lasting psoriasis patients. Sci World J. 2013:901215. doi:10.1155/2013/901215.
Russo C, Jin Z, Homma S, et al. Left atrial minimum volume and reservoir function as correlates of left ventricular diastolic function: impact of left ventricular systolic function. Heart. 2012;98(10):813–20.
To AC, Flamm SD, Marwick TH, et al. Clinical utility of multimodality LA imaging: assessment of size, function, and structure. JACC Cardiovasc Imaging. 2011;4(7):788–98.
Blume GG, Mcleod CJ, Barnes ME, et al. Left atrial function: physiology, assessment, and clinical implications. Eur J Echocardiogr. 2011;12(6):421–30.
Anwar AM, Soliman OI, Geleijnse ML, et al. Assessment of left atrial volume and function by real-time three dimensional echocardiography. Int J Cardiol. 2008;123(2):155–61.
Yildiz A, Ucmak D, Oylumlu M, et al. Assessment of atrial electromechanical delay and P-wave dispersion in patients with psoriasis. Echocardiography. 2014;31(9):1071–6.
Nagueh SF, Appleton CP, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr. 2009;22(2):107–33.
Poutanen T, Jokinen E, Sairanen H, et al. Left atrial and left ventricular function in healthy children and young adults assessed by three dimensional echocardiography. Heart. 2003;89(5):544–9.
Aktürk E, Yağmur J, Kurtoğlu E, et al. Left atrial volume and function in patients with Behcet’s disease assessed by real-time three dimensional echocardiography. Eur Heart J Cardiovasc Imaging. 2012;13(8):650–5.
Bilen E, Kurt M, Tanboğa IH, et al. Assessment of left atrial phasic functions in heart failure patients with preserved or low ejection fractions. Arch Turk Soc Cardiol. 2012;40(2):122–8.
Aksan G, Nar G, Soylu K, et al. Assessment of atrial electromechanical delay and left atrial mechanical functions in patients with psoriasis vulgaris. Echocardiography. 2014:13. doi:10.1111/12706.
Henseler T, Christophers E. Disease concomitance in psoriasis. J Am Acad Dermatol. 1995;32(6):982–6.
Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med. 2005;352(16):1685–95.
Osto E, Piaserico S, Maddalozzo A, et al. Impaired coronary flow reserve in young patients affected by severe psoriasis. Atherosclerosis. 2012;221(1):113–7.
Liu T, Li G, Li L, et al. Association between C-reactive protein and recurrence of atrial fibrillation after successful electrical cardioversion: a meta-analysis. J Am Coll Cardiol. 2007;49(15):1642–8.
Gullu H, Caliskan M, Dursun R, et al. Impaired coronary microvascular function and its association with disease duration and inflammation in patients with psoriasis. Echocardiography. 2013;30(8):912–8.
Coimbra S, Oliveira H, Reis F, et al. C-reactive protein and leucocyte activation in psoriasis vulgaris according to severity and therapy. J Eur Acad Dermatol Venereol. 2010;24(7):789–96.
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Atas, H., Kepez, A., Bozbay, M. et al. Assessment of left atrial volume and function in patients with psoriasis by using real time three-dimensional echocardiography. Wien Klin Wochenschr 127, 858–863 (2015). https://doi.org/10.1007/s00508-015-0817-4
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DOI: https://doi.org/10.1007/s00508-015-0817-4