title: High prevalence of subclinical left ventricular dysfunction in patients with psoriatic arthritis.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Ninety-four PsA patients without clinical evidence of CVD and 63 healthy subjects were enrolled. All underwent conventional echocardiography and tissue Doppler imaging.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  PsA patients without established CVD disease and in the absence of traditional CV risk factors have a high prevalence of subclinical LV dysfunction.
authors: Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
authors: Qing
authors: Q
authors: Shang
authors: Lai-Shan
authors: LS
authors: Tam
authors: Gabriel Wai-Kwok
authors: GW
authors: Yip
authors: John E
authors: JE
authors: Sanderson
authors: Qing
authors: Q
authors: Zhang
authors: Edmund Kwok-Ming
authors: EK
authors: Li
authors: Cheuk-Man
authors: CM
authors: Yu
mesh_terms: D000328:Adult; D015535:Arthritis, Psoriatic / Q000150:complications* / Q000503:physiopathology; D016022:Case-Control Studies; D002681:China; D003430:Cross-Sectional Studies; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology / Q000503:physiopathology; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology