POS1392 ECHOCARDIOGRAPHIC FINDINGS IN PSORIATIC ARTHRITIS, RHEUMATOID ARTHRITIS AND CONTROLS
Authors: A. B. Rodriguez-Romero, J. R. Azpiri-López, I. J. Colunga-Pedraza, D. Á. Galarza-Delgado, N. Guajardo-Jauregui, S. Lugo-Perez, A. Cárdenas, H. Azpiri-Diaz, O. A. Cepeda-Ayala
Journal: Annals of the Rheumatic Diseases (2021)

Background: Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy associated with cardiovascular abnormalities (1). The echocardiography is a non-invasive tool useful in the detection of cardiac abnormalities, which may be the only manifestation of cardiac involvement preceding a global dysfunction. However, echocardiographic differences between PsA patients, rheumatoid arthritis (RA) patients, and controls have not yet been well described. Objectives: To analyze the echocardiographic parameters in PsA patients and to compare them with RA patients and controls. Methods: This cross-sectional, observational and comparative study, included thirty-six patients (nineteen in each group), aged 40-75 years, with PsA and RA who fulfilled the CASPAR (Classification criteria for Psoriatic Arthritis) and ACR/EULAR 2010 classification criteria, respectively, matched by age, gender and comorbidities with nineteen healthy controls. Exclusion criteria were a poor echocardiographic window, patients with a previous atherosclerotic cardiovascular disease (ischemic heart disease, cerebrovascular accident or peripheral arterial disease), and pregnancy. Transthoracic echocardiogram was performed and reviewed by 2 board-certified cardiologists, in all study subjects. Comparisons were done with X2, Kruskall Wallis or ANOVA. Results: There were not differences in the demographic characteristics between groups (Table 1). When comparing echocardiographic findings a statistically significant difference was found in the prevalence of diastolic dysfunction, being more prevalent in PsA and RA patients compared with controls (52.6% vs 52.6% vs 5.3%, p=0.002), likewise the presence of mild mitral valve regurgitation was higher (84.2% vs 53.6% vs 10.5%, p=0.001) and mild pulmonary valve regurgitation (68.4% vs 10.5% vs 0%, p=0.001). Prevalence of abnormal left ventricular geometry was higher in PsA and RA patients than controls (68.4% vs 63.2% vs 21.1%, p=0.006). Table 1. Comparison of demographic characteristics and echocardiographic findings between patients with PsA, RA and controls. PsA (n=19 ) RA (n=19 ) Controls (n=19 ) p Age, years ± SD 54.7 ± 7.7 55.4 ± 9.9 55.3 ± 5.9 NS Female, n (%) 11 (57.9) 11 (57.9) 11 (57.9) NS Diabetes Mellitus 4 (21.1) 3 (15.8) 2 (10.5) NS Hypertension 10 (52.6) 8 (42.1) 7 (36.8) NS Dyslipidemia 10 (52.6) 4 (21.1) 7 (36.8) NS Active smoking 4 (21.1) 2 (10.5) 5 (26.3) NS Disease duration, years (p25-p75) 6 (4-14) 7 (5-18) - NS DAS28-CRP, mean ± SD 2.2 ± 0.8 3.1 ± .8 - 0.003 Echocardiographic findigs Diastolic dysfunction, n (%) 10 (52.6) 10 (52.6) 1 (5.3) 0.002 LV mass index, g/m 2 (p25-p75) 78.9 (55.9-86.9) 73.7 (61.0-85.7) 69.5 (52.0-98.7) NS LVEF, ± mean SD 62.3 ± 6.1 59.7 ± 8.6 62.9 ± 6.1 NS TAPSE, cm ± SD 21.8 ± 2.7 22.4 ± 2.7 23.7 ± 3.1 NS Mild aortic regurgitation, n (%) 5 (26.3) 4 (21.1) 1 (5.3) NS Mild mitral regurgitation, n (%) 16 (84.2) 10 (52.6) 2 (10.5) &lt;0.001 Mild pulmonary regurgitation, n (%) 13 (68.4) 2 (10.5) 0 (0) &lt;0.001 Mild tricuspid regurgitation, n (%) 15 (83.3) 13 (76.5) 11 (57.9) NS LV geometry alterations, n (%) 13 (68.4) 12 (63.2) 4 (21.1) 0.006 Concentric remodeling, n (%) 12 (63.2) 10 (52.6) 4 (21.1) 0.025 NS, non-significant; DAS28-CRP, disease activity score using 28 joints and C reactive protein; LV, left ventricular; LVEF, left ventricular ejection fraction; TAPSE, tricuspid annular plane systolic excursion. Conclusion: This study shows the high prevalence of echocardiographic alterations in PsA patients compared to the general population, of the same magnitude as patients with RA. We emphasize the value of an echocardiogram for a complete cardiovascular evaluation and early detection of cardiac abnormalities in these patients. References: [1]Shang Q, Tam LS, Yip GW, et al. High prevalence of subclinical left ventricular dysfunction in patients with psoriatic arthritis. J Rheumatol 2011;38(7):1363-70. doi: 10.3899/jrheum.101136 Disclosure of Interests: None declared