Jain Hritvik, Jain Jyoti, Dey Debankur, Modi Rishika, Alomari Omar, Ahmed Mushood, Singh Jagjot, Odat Ramez M, Ahmed Raheel, Nashwan Abdulqadir J
Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India.
Department of Internal Medicine, Medical College and Hospital, Kolkata, India.
Clin Cardiol. 2024 Dec;47(12):e70047. doi: 10.1002/clc.70047.
Psoriasis is a systemic inflammatory disease associated with elevated cardiovascular risk due to inflammatory and oxidative stress. Two-dimensional speckle-tracking echocardiography (2D-STE) can detect both regional and global myocardial strain. Impairment of ventricular strain can assist in the early detection of myocardial dysfunction. Subclinical myocardial dysfunction in psoriasis has not yet been elucidated with inconsistent results.
A systematic literature search of various databases was conducted to identify studies comparing global longitudinal strain (GLS) and global circumferential strain (GCS) between patients with psoriasis and healthy controls. Standardized mean differences (SMD) with 95% confidence intervals (CI) were pooled using the inverse-variance random-effects model in Review Manager Software Version 5.4.1.
Eleven studies with 879 participants (501 patients with psoriasis and 378 healthy controls) were included. Psoriasis was associated with a statistically significant reduction in GLS [SMD: -1.04; 95% CI: -1.45, -0.62; p < 0.00001] and GCS [SMD: -0.66; 95% CI: -1.27, -0.05; p = 0.03] compared to healthy controls.
This study demonstrated that patients with psoriasis are at an elevated risk of subclinical myocardial dysfunction, as shown by the reduced GLS and GCS. Early assessment of subclinical impairment in psoriasis will allow targeted intervention and may mitigate future adverse cardiovascular events. Prospective studies with larger sample sizes are warranted to validate these results.
银屑病是一种全身性炎症性疾病，由于炎症和氧化应激，其心血管风险升高。二维斑点追踪超声心动图（2D-STE）可以检测局部和整体心肌应变。心室应变受损有助于早期发现心肌功能障碍。银屑病亚临床心肌功能障碍尚未阐明，结果不一致。
对各种数据库进行系统文献检索，以确定比较银屑病患者和健康对照者整体纵向应变（GLS）和整体圆周应变（GCS）的研究。使用Review Manager软件5.4.1版中的逆方差随机效应模型汇总95%置信区间（CI）的标准化平均差异（SMD）。
纳入11项研究，共879名参与者（501名银屑病患者和378名健康对照者）。与健康对照者相比，银屑病与GLS[SMD：-1.04；95%CI：-1.45，-0.62；p<0.00001]和GCS[SMD：-0.66；95%CI：-1.27，-0.05；p=0.03]的统计学显著降低相关。
本研究表明，银屑病患者存在亚临床心肌功能障碍风险升高，表现为GLS和GCS降低。对银屑病亚临床损伤进行早期评估将有助于进行有针对性的干预，并可能减轻未来的不良心血管事件。需要进行更大样本量的前瞻性研究来验证这些结果。
