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- Title
Relationship between parathyroid hormone and subclinical myocardial dysfunction in patients with severe psoriasis.
- Authors
Zhao, C. ‐ T.; Yeung, C. ‐ K.; Siu, C. ‐ W.; Tam, S.; Chan, J.; Chen, Y.; Chan, H. ‐ H.; Tse, H. ‐ F.; Yiu, K. ‐ H.
- Abstract
Background Psoriasis is associated with an increased risk of cardiovascular disease although the mechanism remains unclear. Recent studies have shown that such patients have a high prevalence of vitamin D (vit-D) deficiency and elevated parathyroid hormone ( PTH) level. We hypothesized that vit-D deficiency and/or elevated PTH in psoriasis may contribute to left ventricular ( LV) dysfunction. Methods Seventy-four patients with severe psoriasis with no known cardiovascular disease and 53 age- and gender-matched controls were recruited. All patients underwent detailed transthoracic echocardiography, including speckle tracking derived strains, and plasma levels of 25-hydoxyvitamin D (25- OHD), PTH and cardiac biomarkers including high sensitive C-reactive protein (hs- CRP), high sensitive troponin I (hs- TNI) and brain natriuretic peptide ( BNP) were measured. Results Despite similar systolic and diastolic LV function, patients with severe psoriasis had impaired LV global longitudinal (−18.1 ± 2.6 vs.−19.6 ± 2.9%, P < 0.01) and circumferential strain (−18.7 ± 3.6 vs. −20.8 ± 4.3%, P < 0.01) compared with controls. Patients with severe psoriasis also had a significantly higher PTH (49.9 ± 18.0 vs. 40.5 ± 15.4 pmol/mL, P < 0.01) and hs-CRP (5.7 ± 6.9 vs. 1.9 ± 2.5 pg/mL, P < 0.01), but similar levels of 25- OHD, hs- TNI and BNP (all P > 0.05) compared with controls. Importantly, PTH level was negatively correlated with LV global longitudinal strain ( R = −0.30, P < 0.01); and higher PTH level was independently associated with impaired global LV longitudinal strain ( R = −0.33, P = 0.04), independent of cardiovascular risk factors, vit-D status and serum biomarkers. Conclusions Severe psoriasis patients had an elevated PTH level and suffered from subclinical LV systolic dysfunction as detected by impaired global LV longitudinal strain. Importantly, a higher PTH level was independently associated with impaired global LV longitudinal strain.
- Subjects
PARATHYROID hormone; CARDIOMYOPATHIES; PSORIASIS; CARDIOVASCULAR diseases; VITAMIN D deficiency
- Publication
Journal of the European Academy of Dermatology & Venereology, 2014, Vol 28, Issue 4, p461
- ISSN
0926-9959
- Publication type
Article
- DOI
10.1111/jdv.12123