Assessment of subclinical left ventricular dysfunction in patients with psoriasis by speckle tracking echocardiography: A Speckle Tracking Study

BACKGROUND: Psoriasis is a systemic inflammatory disease and is reportedly associated with adverse cardiovascular risks. Left ventricular (LV) function has not been studied comprehensively in psoriasis. OBJECTIVES: This study was conducted to study LV mechanics in patients with psoriasis by speckle tracking echocardiography. METHODS: The study population consisted of 40 patients with psoriasis and 35 age- and sex-matched control subjects. Two-dimensional echocardiography images were obtained from LV apical four-chamber (4C), long axis (LAX), and two-chamber (2C) views. Peak longitudinal strain and strain rate were obtained from 4C, LAX, and 2C views. Global strain and strain rate were calculated by averaging data for the three apical views. RESULTS: Patients with psoriasis had significantly lower mean ± standard deviation (SD) 4C (17.1 ± 1.7 vs. 19.2 ± 2.3; P < 0.01), LAX (16.6 ± 1.5 vs. 19.5 ± 2.3; P < 0.01), and 2C (16.5 ± 1.5 vs. 19.4 ± 2.2; P < 0.01) peak longitudinal strain values compared with the control group. Moreover, mean ± SD LV global strain (16.6 ± 1.5 vs. 19.9 ± 2.1; P < 0.01) and strain rate (1.39 ± 0.30 vs. 1.51 ± 0.20; P < 0.01) values were found to be significantly lower in the psoriasis group. In a multiple regression model, global strain was independently associated with high-sensitivity C-reactive protein (β = 0.29, P = 0.04), duration of disease (β = 0.35, P < 0.01), ejection fraction (EF) (β = 0.38, P =0.01), and the ratio of early diastolic mitral inflow velocity to early diastolic annular velocity (E/E' ratio) (β = 0.34, P =0.02). Also, in a multiple regression model, global strain rate was independently associated with duration of disease (β = 0.36, P < 0.01), EF (β = 0.32, P = 0.01), and E/E' ratio (β = 0.35, P < 0.01). CONCLUSIONS: Using 2-D strain imaging, we have demonstrated that patients with psoriasis have lower LV functions.