SAT0311 Prevalence and factors related to inappropriately high left ventricular mass in patients with psoriatic arthritis without overt cardiac disease. (12th June 2018)

• Record Type: Journal Article
• Authors: Giollo, A.; Farina, N.; Orsolini, G.; Cioffi, G.; Ognibeni, F.; Idolazzi, L.; Gatti, D.; Rossini, M.; Viapiana, O.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1020
• Page End: 1020
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.2953
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Early cardiovascular (CV) involvement has been found in patients with psoriatic arthritis (PsA). These patients may have a high prevalence of subclinical left ventricular (LV) dysfunction, even without established CV disease and in the absence of traditional CV risk factors. However, currently, the factors associated with LV dysfunction in PsA are unknown. Patients with inflammatory disorders are exposed to the development of excessive left ventricular mass disproportionate to the need to compensate left ventricular load, a condition named 'inappropriately high left ventricular mass' (iLVM). Previously, we have shown that iLVM is associated with unfavourable prognosis in patients with rheumatoid arthritis independent of traditional CV risk factors. Objectives: In this cross-sectional study, we assessed the prevalence and factors associated with iLVM in a cohort of patients with PsA and tested the hypothesis that PsA is per se related to iLVM. Methods: We evaluated 101 non-institutionalised patients>18 years of age diagnosed with PsA according to CASPAR criteria and consecutively recruited between March 2014 and December 2016. All PsA patients were free of symptoms or signs of cardiovascular disease. Patients with PsA were compared with 101 controls matched for age, sex, BMI, prevalence of hypertension and diabetes. Left ventricular chamber dimensions and wall thicknesses were measured according to the American Society of Echocardiography guidelines and predicted LVM was calculated using a validated equation considering height, sex and left ventricular work. iLVM was defined as measured/predicted LVM ratio above the 95% percentile of a reference population of healthy controls. 1 Results: iLVM was detected in 58% of patients with PsA and 18% of controls (p<0.001). In multivariable logistic regression analysis considering only patients with PsA, the variables independently associated with iLVM were left ventricular systolic dysfunction (LVSD) measured as mid-wall shortening and concentric left ventricular geometry. In multiple regression analyses considering the entire study population (patients with PsA and matched controls), the diagnosis of PsA was significantly associated with iLVM independent of traditional cardiovascular risk factors (OR 6.91, 95% CI 2.80–17.06, p<0.001; table 1). Conclusions: More than 50% of patients with PsA have a disproportionate increase in their LVM. An inappropriately high LVM in PsA is associated with LV systolic dysfunction and LV concentric geometry. Reference: [1] Cioffi G, Viapiana O, Ognibeni F, Dalbeni A, Giollo A, Adami S, Gatti D, Russo G, Barbati G, Cherubini A, Di Lenarda A, Rossini M. Prevalence and factors related to inappropriately high left ventricular mass in patients with rheumatoid arthritis without overt cardiac disease. J Hypertens2015;33:2141–2149. Disclosure of Interest: None declared