Abstract Background Psoriatic arthritis (PsA) is a systemic inflammatory disease linked to accelerated atherosclerosis and increased cardiovascular (CV) risk. Patients with moderate to severe skin involvement exhibit a heightened risk of CV events, likely due to systemic inflammation. The Psoriasis Area and Severity Index (PASI) quantifies skin involvement, which may drive immune activation, cytokine secretion, and potential alterations in ventricular geometry, diastolic, and systolic function. Objective To evaluate the association between active skin involvement, carotid plaque (CP), left ventricular geometry, and cardiac function in PsA patients. Methods We conducted a cross-sectional study including PsA patients (35–75 years) meeting the 2006 CASPAR criteria. Exclusion criteria were prior CV disease, pregnancy, and overlap syndrome. Patients were stratified by skin involvement: active (PASI 1) and inactive (PASI ≤1). Carotid ultrasound assessed CP (defined as cIMT ≥1.2 mm or focal thickness ≥0.5 mm) and carotid hyperplasia (cIMT ≥0.8 mm). Echocardiography evaluated cardiac geometry, diastolic, and systolic function per 2016 ASE/EACVI criteria. Normality was assessed via Kolmogorov-Smirnov test; comparisons used Student’s t-test, Chi-square, and Mann-Whitney U test. Statistical significance was set at p ≤ 0.05. Results A total of 78 patients were analyzed, classified based on skin involvement. Those with active skin involvement were younger (50.00 vs. 55.41 years, p = 0.050), with a similar female distribution (65.90% vs. 58.82%, p = 0.521). CV risk factors were comparable, except for diabetes mellitus (DM), which was more prevalent in the active group (25.00% vs. 5.88%, p = 0.025). Obesity, hypertension (HTN), dyslipidemia (DLP), and treatments showed no significant differences. Carotid ultrasound findings revealed no significant differences in CP prevalence (45.45% vs. 35.29%, p = 0.423) or carotid hyperplasia (12.82% vs. 9.67%, p = 0.604). Echocardiographic analysis showed a higher prevalence of eccentric hypertrophy in the active group (29.54% vs. 8.82%, p = 0.025) and a significantly higher left ventricular mass index (LVMI) (91.89 vs. 71.56 g/m², p = 0.002). No differences were observed in relative wall thickness (RWT) or systolic and diastolic function parameters, including left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), and pulmonary systolic arterial pressure (PSAP). Conclusion PsA patients with active skin involvement exhibited higher LVMI and eccentric hypertrophy, suggesting early cardiac remodeling. However, no significant differences were found in CV risk factors, carotid ultrasound findings, or cardiac function parameters. These results highlight the importance of echocardiography in the CV assessment of PsA patients with ongoing cutaneous disease.
Flores et al. (Sat,) studied this question.