Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
J Rheumatol. 2011 Jul;38(7):1363-70. doi: 10.3899/jrheum.101136. Epub 2011 Apr 1.
Endothelial dysfunction and early atherosclerosis have been found in patients with psoriatic arthritis (PsA) without cardiovascular disease (CVD) risk factors. Few studies have investigated whether there is any early impairment of myocardial function. The aims of our study were to determine the prevalence of subclinical left ventricular (LV) dysfunction in PsA patients and the disease-related risk factors.
Ninety-four PsA patients without clinical evidence of CVD and 63 healthy subjects were enrolled. All underwent conventional echocardiography and tissue Doppler imaging.
Sixty-one (65%) patients with PsA had evidence of subclinical LV dysfunction as defined by mean myocardial peak systolic velocity (Sm) of basal 6 segments < 4.4 cm/s, lateral E' < 11.5 cm/s, and/or lateral E/E' > 10. Thirty-six (38%) patients had only diastolic dysfunction, 4 (4%) had only systolic dysfunction, and 21 (22%) had both systolic and diastolic dysfunction. PsA patients with subclinical LV dysfunction were older, had a higher age at diagnosis of PsA and of psoriasis, a longer disease duration, a higher prevalence of hypertension and hyperlipidemia, higher levels of serum creatinine, and more antihypertensive treatment than those with normal LV function. Multivariate regression showed that age at diagnosis of PsA > 40 years (OR 3.388, 95% CI 1.065-10.777, p = 0.039) and hypertension (OR 4.732, 95% CI 1.345-16.639, p = 0.015) were independent predictors of subclinical LV dysfunction.
PsA patients without established CVD disease and in the absence of traditional CV risk factors have a high prevalence of subclinical LV dysfunction.
在没有心血管疾病（CVD）危险因素的银屑病关节炎（PsA）患者中，已经发现内皮功能障碍和早期动脉粥样硬化。很少有研究调查是否存在任何早期心肌功能障碍。我们的研究目的是确定 PsA 患者亚临床左心室（LV）功能障碍的患病率以及与疾病相关的危险因素。
共纳入 94 例无临床 CVD 证据的 PsA 患者和 63 例健康对照者。所有患者均接受常规超声心动图和组织多普勒成像检查。
61 例（65%）PsA 患者存在亚临床 LV 功能障碍的证据，定义为基底 6 节段平均心肌收缩期峰值速度（Sm）<4.4cm/s、侧壁 E'<11.5cm/s 和/或侧壁 E/E'<10。36 例（38%）患者仅存在舒张功能障碍，4 例（4%）仅存在收缩功能障碍，21 例（22%）同时存在收缩和舒张功能障碍。亚临床 LV 功能障碍的 PsA 患者年龄较大，PsA 和银屑病的诊断年龄较大，疾病持续时间较长，高血压和高脂血症的患病率较高，血清肌酐水平较高，接受抗高血压治疗的比例较高。多变量回归分析显示，PsA 的诊断年龄>40 岁（OR 3.388，95%CI 1.065-10.777，p=0.039）和高血压（OR 4.732，95%CI 1.345-16.639，p=0.015）是亚临床 LV 功能障碍的独立预测因素。
无明确 CVD 疾病且无传统 CV 危险因素的 PsA 患者存在亚临床 LV 功能障碍的高患病率。
