Features of myocardial involvement in patients with psoriatic arthritis

Psoriatic arthritis (PsA) is a chronic inflammatory arthritis associated with psoriasis and an increased risk of cardiovascular complications. Systemic inflammation and excessive production of proinflammatory cytokines contribute to myocardial remodeling and the development of subclinical dysfunction. Of particular interest is the relationship between joint inflammatory changes and cardiac dysfunction in PsA.

Objective: To determine the features of myocardial involvement in patients with psoriatic arthritis depending on joint changes.

Materials and methods: A total of 74 patients with PsA, 43 men, 31 women; mean age (50.5 ± 12.4) years, who received outpatient and inpatient treatment were examined. All patients underwent standard laboratory tests, transthoracic echocardiography with pulsed-wave and tissue Doppler imaging, as well as ultrasound examination of the joints. Echocardiography assessed systolic and diastolic function, left ventricular (LV) mass, and geometry. Synovitis and enthesitis were identified by joint ultrasound. Statistical analysis was performed using standard methods, with significance set at p < 0.05.

Results: Disease duration correlated with impaired diastolic function of both ventricles. High disease activity according to the DAPSA index and elevated C-reactive protein levels were associated with reduced LV ejection fraction. The presence of synovitis and enthesitis was accompanied by increased myocardial mass and signs of diastolic dysfunction.

Conclusions: In patients with PsA, a relationship was established between joint inflammatory changes and cardiac dysfunction, highlighting the need for comprehensive monitoring to ensure early detection of cardiovascular complications.