Indicators of longitudinal deformation of the left atrium in patients with hypertension and psoriasis

The aim of the study. To evaluate the severity of left atrial remodeling by measuring global longitudinal myocardial strain in patients with hypertension and concomitant psoriasis followed by the assessment of the effect on the frequency of cardiac arrhythmias.

Materials and methods. A prospective cohort study was conducted including the patients with hypertension and psoriasis compared with a group of patients with hypertension without psoriasis. The patients underwent a clinical diagnostic examination with an emphasis on daily ECG monitoring, echocardiographic examination to determine the longitudinal deformation of the left ventricle and left atrium. 96 patients with hypertension were examined in the course of the study. The patients were divided into two groups: the main group group 1 (n = 60 patients) – patients with hypertension and psoriasis, the control group – group 2 (n = 36 patients) – patients with hypertension without concomitant psoriasis.

Results. The patients of both groups had a statistically equal distribution by age, gender, and anthropometric characteristics, hemodynamic parameters at the time of inclusion in the study, the duration of hypertension, and the structure of concomitant pathology. In the group of patients with psoriasis, frequent supraventricular extrasystole and paroxysms of unstable supraventricular tachycardia were significantly more common: 43.13 % in group 1 and 26.21 % in group 2 (p = 0.031). Besides, in patients with hypertension and concomitant psoriasis, a decrease in left atrial myocardial strain in the reservoir phase was more frequent (LASr = 23.12 ± 5.64 in the group of patients with psoriasis and 28.31 ± 6.36 in the control group (p = 0.004)), with comparable strain readings in the flow and contraction phases. In addition, in Group 1, there was a greater severity of left ventricular diastolic dysfunction according to tissue dopplerography (E/e’ = 11.42+/–2.47 in Group 1 and 9.21+/–2.22 in Group 2 (p = 0.0065)).

Conclusion. According to our data, patients with hypertension and concomitant psoriasis were significantly more likely to have left atrial strain in the reservoir phase, as well as more pronounced diastolic dysfunction of the left ventricle, assessed by tissue dopplerography, which was combined with more frequent paroxysms of unstable supraventricular tachycardia.

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