title: Increase in ventricular-arterial stiffness in patients with psoriatic arthritis.
abstract: OBJECTIVE
  Ventricular and arterial stiffness is an accepted cause of myocardial diastolic dysfunction. The aim of this study is to determine whether there is increased ventricular and arterial stiffness in patients with PsA and any relationship with disease-related risk factors.
  
  
  METHODS
  Seventy-three patients with PsA were divided into two subgroups based on the absence or presence of hypertension and/or left ventricular (LV) hypertrophy. Fifty healthy controls were enrolled for comparison. All participants underwent non-invasive assessments including conventional echocardiography with tissue Doppler imaging and pulse wave analysis. Ventricular stiffness was measured by ventricular end-systolic and diastolic elastance, whereas arterial stiffness was measured by total arterial compliance and aortic augmentation index.
  
  
  RESULTS
  There was significantly increased ventricular and arterial stiffness in patients with PsA (P < 0.001), even in those without hypertension and/or LV hypertrophy. Based on the cut-off points derived from the controls, 38.4% of PsA patients had increased LV stiffness including 31.5% in diastole and 17.8% in systole, and 15.1% had increased arterial stiffness. Multivariable logistic regression analysis showed that long PsA disease duration (>10 years) (odds ratio = 6.55, P = 0.001) was an independent risk factor for increased LV diastolic elastance after adjusting for age, gender and hypertension.
  
  
  CONCLUSIONS
  Patients with PsA may have increased ventricular and arterial stiffness even without evidence of LV remodelling, and those with long disease duration may be at a higher risk. Therefore, prolonged inflammatory burden may be an important cause of early cardiovascular disease in patients with PsA.
authors.affiliation: Division of Cardiology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Shang
authors.forename: Lai-Shan
authors.initials: LS
authors.lastname: Tam
authors.forename: John E
authors.initials: JE
authors.lastname: Sanderson
authors.forename: Jing-Ping
authors.initials: JP
authors.lastname: Sun
authors.forename: Edmund Kwok-Ming
authors.initials: EK
authors.lastname: Li
authors.forename: Cheuk-Man
authors.initials: CM
authors.lastname: Yu
mesh_terms: D000328:Adult; D015535:Arthritis, Psoriatic / Q000150:complications / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000503:physiopathology*; D008297:Male; D059289:Vascular Stiffness / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology; D020257:Ventricular Remodeling / Q000502:physiology