title: Assessment of arterial stiffness and cardiovascular hemodynamics by oscillometric method in psoriasis patients with normal cardiac functions.
abstract: Arterial stiffness is associated with increased cardiovascular risk. Pulse wave velocity (PWV) and augmentation index (AIx) are non-invasive markers for assessment of arterial stiffness. Increased arterial stiffness is associated with atherosclerosis in patients with psoriasis. Previous studies have shown that high neutrophil-to-lymphocyte ratio (NLR) predicts poor cardiovascular outcome. The aim of this study was to evaluate arterial stiffness and cardiovascular hemodynamics by oscillometric method in psoriasis patients with normal cardiac functions. Fifty consecutive patients with the diagnosis of psoriasis and 50 controls were included in the study. NLR was calculated as the ratio of neutrophil count to lymphocyte count. All patients underwent echocardiographic examination. Measurements of arterial stiffness were carried out using a Mobil-O-Graph arteriograph system. Fifty patients with psoriasis (26 male, mean age 43.3 ± 13.2 years) and 50 controls (33 male, mean age 45.0 ± 6.1 years) were included into the study. The distribution of cardiovascular risk factors was similar between the two groups, and NLR was significantly higher in patients with psoriasis (2.74 ± 1.78 versus 1.82 ± 0.52, p = 0.002). There was a weak correlation between NLR and PASI score without reaching statistical significance (r = 0.300, p = 0.060). While echocardiographic and hemodynamic parameters were comparable between psoriasis and control groups, heart rate was significantly higher in psoriasis group (81.5 ± 15.1 and 75.2 ± 11.8 beats/min, p = 0.021). Psoriasis patients had significantly higher AIx and PWV values as compared to controls (25.8 ± 13.1 versus 17.4 ± 12.3%, p = 0.001 and 6.78 ± 1.42 versus 6.18 ± 0.80 m/s, p = 0.011, respectively). AI and PWV were significantly associated with psoriasis when adjusted by heart rate (p = 0.005, odds ratio 1.04, 95% confidence interval 1.01-1.08 and p = 0.035, odds ratio 1.52, 95 % confidence interval 1.02-2.26, respectively). PWV significantly correlated with blood pressure, lipid levels, and several echocardiographic indices. AIx only correlated with left atrial diameter (r = 291, p = 0.040). Linear regression analysis was performed to find predictors of PWV. Central systolic blood pressure, left atrial diameter, and total cholesterol were independent predictors of PWV. PWV and AIx were significantly higher in patients with psoriasis. Assessment of arterial stiffness parameters may be useful for early detection of cardiovascular deterioration in psoriasis patients with normal cardiac functions. Novel inflammatory biomarkers such as NLR may elucidate the mechanism of vascular dysfunction in such patients.
authors.affiliation: Marmara University Faculty of Medicine, Department of Cardiology, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Sunbul
authors.forename: Dilek
authors.initials: D
authors.lastname: Seckin
authors.forename: Erdal
authors.initials: E
authors.lastname: Durmus
authors.forename: Zuleyha
authors.initials: Z
authors.lastname: Ozgen
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bozbay
authors.forename: Ayfer
authors.initials: A
authors.lastname: Bozbay
authors.forename: Tarik
authors.initials: T
authors.lastname: Kivrak
authors.forename: Mustafa
authors.initials: M
authors.lastname: Oguz
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Sari
authors.forename: Tulin
authors.initials: T
authors.lastname: Ergun
authors.forename: Mehmet
authors.initials: M
authors.lastname: Agirbasli
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D016017:Odds Ratio; D009991:Oscillometry / Q000379:methods*; D011237:Predictive Value of Tests; D011565:Psoriasis / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D063177:Pulse Wave Analysis; D012307:Risk Factors; D059289:Vascular Stiffness