Linde Anja, Gerdts Eva, Tveit Kåre Steinar, Kringeland Ester, Midtbø Helga
Norwegian Research Centre for Women's Health, Oslo University Hospital, 0424 Oslo, Norway.
Department of Clinical Science, University of Bergen, 5020 Bergen, Norway.
J Clin Med. 2021 May 31;10(11):2440. doi: 10.3390/jcm10112440.
We explored the association between subclinical cardiac organ damage (OD) with comorbidities and psoriasis severity in 53 psoriasis patients on infliximab treatment (age 47 ± 15 years, 30% women) and 99 controls without psoriasis (age 47 ± 11 years, 28% women). Cardiac OD was assessed by echocardiography as the presence of increased left ventricular (LV) relative wall thickness (RWT), LV hypertrophy or dilated left atrium. Psoriasis severity was graded using the psoriasis area and severity index (PASI). The prevalence of hypertension was 66% in psoriasis vs. 61% in controls ( = 0.54) and cardiac OD seen in 51 and 73%, respectively ( = 0.007). Psoriasis was associated with a lower prevalence of cardiac OD (odds ratio (OR) 0.32, 95% confidence interval (CI) 0.13-0.77, = 0.01) independent of age, sex, smoking, body mass index, and hypertension. Among psoriasis patients, hypertension was associated with increased risk of subclinical cardiac OD (OR 6.88, 95% CI 1.32-35.98, = 0.02) independent of age, sex, and body mass index. PASI at treatment initiation was associated with a higher RWT at follow-up, independent of sex, age, and hypertension (β 0.36, = 0.006) while no association with current PASI was found. In conclusion, cardiac OD was less prevalent in psoriasis patients on infliximab treatment than controls. Hypertension was the major covariable for subclinical cardiac OD in psoriasis.
我们在53例接受英夫利昔单抗治疗的银屑病患者（年龄47±15岁，30%为女性）和99例无银屑病的对照者（年龄47±11岁，28%为女性）中，探讨了亚临床心脏器官损害（OD）与合并症及银屑病严重程度之间的关联。通过超声心动图评估心脏OD，以左心室（LV）相对壁厚度（RWT）增加、LV肥厚或左心房扩大为判断标准。使用银屑病面积和严重程度指数（PASI）对银屑病严重程度进行分级。银屑病患者中高血压患病率为66%，对照者为61%（P=0.54），心脏OD的发生率分别为51%和73%（P=0.007）。银屑病与心脏OD的较低患病率相关（优势比（OR）0.32，95%置信区间（CI）0.13 - 0.77，P=0.01），且独立于年龄、性别、吸烟、体重指数和高血压。在银屑病患者中，高血压与亚临床心脏OD风险增加相关（OR 6.88，95%CI 1.32 - 35.98，P=0.02），且独立于年龄、性别和体重指数。治疗开始时的PASI与随访时较高的RWT相关，独立于性别、年龄和高血压（β 0.36，P=0.006），而未发现与当前PASI有关联。总之，接受英夫利昔单抗治疗的银屑病患者中心脏OD的患病率低于对照者。高血压是银屑病中亚临床心脏OD的主要协变量。
