Assessment of arterial stiffness and cardiovascular hemodynamics by oscillometric method in psoriasis patients with normal cardiac functions

Sünbül, Murat; Seçkin, Dilek; Durmuş, Erdal; Özgen, Züleyha; Bozbay, Mehmet; Bozbay, Ayfer Yıldız; Kıvrak, Tarık; Oğuz, Mustafa; Sarı, İbrahim; Ergun, Tülin; Ağırbaşlı, Mehmet

doi:10.1007/s00380-014-0490-y

Cited by 27 publications

(16 citation statements)

References 44 publications

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“…Pulse wave velocity and augmentation index, non-invasive markers for assessment of arterial stiffness, were found to be significantly higher in patients with Ps [12].…”

Section: Discussionmentioning

confidence: 95%

Increased prevalence of early repolarization in electrocardiograms of psoriatic patients

et al. 2014

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Psoriasis (Ps) is a chronic-relapsing, inflammatory, and proliferative condition of the skin: prior studies hypothesized a link between Ps and anomalies in β-adrenergic tone. We therefore aimed to ascertain the prevalence of early repolarization pattern (ERP) in resting electrocardiograms (ECGs) of psoriatic patients compared with an appropriate control group. We performed a retrospective study of resting ECGs of 100 consecutive psoriatic patients and 100 healthy controls. The presence of ERP in at least two contiguous leads at rest ECG was recorded, and findings were also categorized according to the lead group where ERP was detected (anterior, lateral, inferior). An ERP in ≥ 2 contiguous leads occurred in 40 % of psoriatic patients, compared with 14 % of control subjects (p < 0.001). (36 vs 10 % in anterior leads, p < 0.001; 6 vs 3 % in inferior leads, p n.s.; 10 vs 2 % in lateral leads). After adjustment for sex, age, heart rate, and level of physical activity, the odds ratios for the presence of ERP were 8.6 (95 % CI, 2.1-35.2, p < 0.01), and 7.1 (95 % CI, 1.6-31.8, p < 0.05) in anterior leads. In a small case/control study, increased rates of ECGs showing ERP have been observed among psoriatic patients. Clinical significance of such finding needs to be assessed in further observational studies.

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“…Pulse wave velocity and augmentation index, non-invasive markers for assessment of arterial stiffness, were found to be significantly higher in patients with Ps [12].…”

Section: Discussionmentioning

confidence: 95%

Increased prevalence of early repolarization in electrocardiograms of psoriatic patients

et al. 2014

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“…Also, increased arterial stiffness was associated with atherosclerosis [24]. Previous reports found that BP variability was a significant indicator for arterial atherosclerosis and stiffness in patients at high risk of cardiovascular disease.…”

Section: Discussionmentioning

confidence: 97%

Differences in ward-to-cath lab systolic blood pressure predicts long-term adverse outcomes after drug-eluting stent implantation

et al. 2014

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We sought to investigate the effect of ward-to-cath lab blood pressure (BP) differences on long-term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stent (DES). There are limited data available on the association between PCI with DES and BP differences on long-term clinical outcomes. This study enrolled 994 patients who underwent PCI with DES from March 2003 to August 2007. Resting BP was measured in a ward environment before transfer to the cardiac catheterization lab (cath lab), and again when the patient was laid down on the cath lab table. Patients were divided into two groups according to the difference in ward-to-cath lab systolic BP. Large difference group (n = 383) was defined as the absolute systolic difference of >20 mmHg and small difference group (n = 424) as the absolute systolic difference of ≤20 mmHg. The primary endpoints were all-cause mortality, cardiac death, nonfatal myocardial infarction and stroke. A total of 807 patients (mean age 60 ± 10 years, 522 males) received follow-up for 5.1 ± 2.4 years. The rate of all-cause mortality was significantly higher in the large difference group compared to the small difference group (6.6 vs. 2.8 %; adjusted hazard ratio (HR) 2.43; 95 % confidence interval (CI) 1.22-4.83; p = 0.012). There were higher cardiac deaths seen in the large difference group compared to the small difference group (3.9 vs. 1.4 %; adjusted HR 2.84; 95 % CI 1.1-7.31; p = 0.031). Stroke (2.4 vs. 1.2 %, p = 0.125) and TVR (3.7 vs. 1.7 %, p = 0.051) had higher trends in the large difference group compared to the small difference group. The composite of primary endpoints (all-cause mortality, cardiac death, nonfatal MI and stroke) occurred more frequently in the large difference group compared to the small difference group (10.0 vs. 6.4 %; adjusted HR 1.71; 95 % CI 1.04-2.81; p = 0.033). A difference in ward-to-cath lab systolic BP of >20 mmHg may contribute to increased adverse outcomes in the form of all-cause mortality and cardiac deaths in patients undergoing PCI with DES.

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“…The initiation of atherosclerosis is characterized by activation of the vascular endothelium [23]. We previously reported that patients with psoriasis had reduced vascular function [24]. We used an oscillometric technique for the assessment of arterial stiffness parameters and cardiovascular hemodynamics in patients with psoriasis.…”

Section: Discussionmentioning

confidence: 99%

Growth Arrest‐Specific 6 and Cardiometabolic Risk Factors in Patients with Psoriasis

Sünbül

Cagman

Gerin³

et al. 2015

Cardiovascular Therapeutics

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SUMMARYObjectives: An increased risk for cardiovascular disease with psoriasis has been reported. Growth Arrest-Specific 6 (GAS6) amplifies pro-inflammatory endothelial cell activation via TAM receptors. However, it also inhibits inflammation by multiple mechanisms including phagocytosis. The objective of this study was to investigate whether plasma GAS6 levels are associated with conventional cardiometabolic (CM) risk factors in patients with psoriasis. Methods: Forty patients diagnosed with psoriasis (22 male, mean age: 43.3 AE 13.8 years) and 40 age-/sex-matched healthy controls (22 male, mean age: 39.3 AE 8.9 years) were included in the study. CM risk factors (hypertension, hyperlipidemia, diabetes mellitus, and cigarette smoking) were identified. GAS6 levels were measured by ELISA. Results: There were no significant differences between the plasma GAS6 levels of patients with psoriasis compared to the control group (6.6 AE 2.0 ng/mL, 7.6 AE 2.8 ng/mL, respectively, P > 0.05). However, GAS6 levels of patients with psoriasis having a smoking history (n = 11) were significantly lower than both patients with psoriasis who had no smoking history (n = 29) and controls (5.5 AE 1.7 ng/mL, 6.9 AE 1.9 ng/mL, 7.6 AE 2.8 ng/mL, respectively, P < 0.05). Similarly, psoriasis patients with at least one CM risk factor showed lower GAS6 levels compared to subjects without any CM risk factor (5.7 AE 1.7 ng/mL, 7.3 AE 2.0 ng/mL, P < 0.01). There was no correlation between the GAS6 level, disease duration or PASI score (r = 0.150, À0.150, and P = 0.310, 0.398, respectively). Conclusions: This pilot study provides the first evidence in humans for an association between low plasma GAS6 levels and conventional risk factors in psoriasis. Further large scale, prospective studies are needed to confirm these results.

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Assessment of arterial stiffness and cardiovascular hemodynamics by oscillometric method in psoriasis patients with normal cardiac functions

Cited by 27 publications

References 44 publications

Increased prevalence of early repolarization in electrocardiograms of psoriatic patients

Increased prevalence of early repolarization in electrocardiograms of psoriatic patients

Differences in ward-to-cath lab systolic blood pressure predicts long-term adverse outcomes after drug-eluting stent implantation

Growth Arrest‐Specific 6 and Cardiometabolic Risk Factors in Patients with Psoriasis

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