AB0784 SUBCLINICAL MYOCARDIAL INVOLVEMENT IN PSORIATIC ARTHRITIS PATIENTS
Authors: Nikolaos Tsigaridas, Stavros Mantzoukis, Eleni Toli, Konstantinos Tsimos, Nikolaos Varsamis, Maria Gianniki, Marina Gerasimou, Dimitrios Patsouras, Niki Tsifetaki
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Psoriatic arthritis (PsA) is a systemic inflammatory disease affecting 15-30% of patients with psoriasis<sup>1</sup>. Patients with PsA present 43% higher risk of cardiovascular disease, involving myocardial infarction, heart failure and cerebrovascular events compared with the general population<sup>2</sup>. The common underlying pathophysiologic basis of these clinical events is early atherosclerosis. Myocardial fibrosis in the context of systemic inflammation<sup>3</sup> seems to play a significant role in the cardiac manifestations of the disease as well. However, only a few trials have evaluated the possibility of recognition of myocardial involvement in its subclinical phase, which might be of value in reducing the morbidity and mortality of the disease. <h3>Objectives:</h3> Our goal was to evaluate the systolic and diastolic myocardial function in asymptomatic patients with PsA and no cardiac comorbidities and emphasize the value of speckle tracking echocardiography in this condition. <h3>Methods:</h3> Sixty patients (29 males) and 34 healthy controls (18 males) participated in the study. The patients' mean age was 52.5 (s.d = 11.29) and the controls' mean age was 50.7 years (s.d. = 17.42). They were all subjected to 2D transthoracic echocardiography, tissue Doppler imaging, and speckle tracking echocardiography, in order to evaluate left ventricular systolic function with conventional indices such as ejection fraction (EF), and with novel indices such as global longitudinal strain (GLS). Diastolic dysfunction was also assessed in both groups. Blood tests including CRP and ESR were conducted. Disease duration and severity scores, PASI and DAS 28, were also recorded. The statistical analysis was conducted with SPSS v.23.0. <h3>Results:</h3> Linear regression analysis showed statistically significantly impaired left ventricular systolic function (p&lt;0,001), as assessed with global longitudinal strain (GLS), in PsA patients (mean =-19.79, s.d. =4.54) compared to the controls (mean =-23.67, s.d. =3.27). The results were adjusted for age and gender. Ejection fraction, on the contrary, did not show any statistically significant difference between the two groups (p=0,535). Left ventricular diastolic function did not present significant difference between the two groups. GLS showed no association with disease duration, severity scores or the blood tests. <h3>Conclusion:</h3> PsA patients present a higher risk of left ventricular systolic dysfunction compared to controls. GLS measured by speckle tracking echocardiography is a useful tool in revealing this subclinical myocardial impairment. <h3>References</h3> [1] Gladman DD, antoni C, Mease P, Clegg DO, Nash P. Psoriatic arthritis: epidemiology, clinical features, course, and outcome. Ann Rheum Dis2005;64Suppl 2:ii14–7 [2] Polachek a, Touma Z, anderson M, Eder L. Risk of Cardiovascular Morbidity in Patients with Psoriatic arthritis: a Meta-Analysis of Observational Studies. Arthritis Care &amp; Research Vol. 69, No. 1, January2017, pp 67–74 [3] Kania G, Blyszczuk P, Eriksson U. Mechanisms of cardiac fibrosis in inflammatory heart disease. Trends Cardiovasc Med2009; 19: 247-252 <h3>Disclosure of interests:</h3> None declared