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Subclinical cardiovascular disease and it's improvement after long‐term TNF ‐α inhibitor therapy in severe psoriatic patients
Author(s) -
Herédi E.,
Végh J.,
Pogácsás L.,
Gáspár K.,
Varga J.,
Kincse G.,
Zeher M.,
Szegedi A.,
Gaál J.
Publication year - 2016
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.13649
Subject(s) - medicine , subclinical infection , cardiology , psoriasis , psoriatic arthritis , tumor necrosis factor alpha , disease , gastroenterology , immunology
Background There are conflicting data on the occurrence of subclinical myocardial dysfunction in psoriatic patients and on the impact of long‐term tumour necrosis factor‐alpha ( TNF ‐α) inhibitor therapy on cardiac function. Objective In this study, we explored whether there are any signs of subclinical cardiovascular disease (echocardiographic abnormalities) in severe psoriatic patients without clinically overt heart disease. As a second objective, the influence of long‐term treatment with TNF ‐α inhibitors on the ventricular functions of psoriatic patients was also investigated. Methods Clinical and echocardiographic data from 44 psoriatic patients and 45 age‐ and sex‐matched controls were processed. As a first step, the echocardiographic parameters of psoriatic patients obtained before anti‐ TNF ‐α treatment were compared with controls. As a second step, to detect the effect of long‐term anti‐ TNF ‐α treatment on echocardiographic parameters, data of patients before and after therapy were analysed. Results The right ventricular Tei index was higher ( P < 0.001), whereas the tricuspid annular plane systolic excursion ( TAPSE ) and right ventricular free wall peak systolic velocity were lower ( P < 0.001 and P < 0.0001, respectively) in the psoriatic patients than in the controls. Following treatment with TNF ‐α inhibitors, TAPSE and right ventricular free wall peak systolic velocity significantly improved ( P < 0.0001 for both parameters). The Tei index of both ventricles improved during biological therapy; however, this change did not reach statistical significance. Conclusion Patients with severe psoriasis exhibit signs of subclinical cardiovascular disease compared to control, and prolonged anti‐ TNF ‐α therapy has a potentially beneficial effect on these signs.