Abstract
Purpose. Psoriasis vulgaris is one of the most common skin disorders. Patients with psoriasis carry an excessive risk of atrial fibrillation (AF). The differences between the maximum (Pmax) and the minimum (Pmin) P-wave duration on ECG are defined as P-wave dispersion (PWD). Prolongation of PWD is an independent risk factor for the development of AF. The aim of this the study was to investigate P-wave duration and PWD in patients with psoriasis.Methods. Sixty-one adult patients with psoriasis vulgaris (group 1) and 58 age and sex-matched healthy individuals (group 2) were included in this study. ECG recordings were obtained, and the P-wave variables were calculated. Results were reported as mean ± standard deviation and percentages. Continuous variables were analysed using Student's t test. A value of P < 0.05 was considered statistically significant.Results. Pmax and PWD were significantly higher in group 1 than in group 2 (108.8 ± 21.3 ms versus 93.3 ± 13.0 ms, P < 0.001; 67.4 ± 22.9 ms versus 45.0 ± 19.6 ms, P < 0.001, respectively). Also, Pmin was significantly lower in group 1 (41.3 ± 12.3 ms versus 48.3 ± 14.3 ms, P = 0.04). The psoriasis disease activity score and hsCRP correlated with PWD (P < 0.01).Conclusions. Atrial conduction of sinus impulses was impaired in patients with psoriasis vulgaris. It was more prominent in patients with severe disease. Physicians caring for patients with psoriasis vulgaris should screen them for AF development.
Highlights
Psoriasis vulgaris is one of the most prevalent T-cellmediated, chronic, multisystemic, inflammatory diseases and is characterized by epidermal hyperproliferation, abnormal keratinocyte differentiation, T-lymphocyte infiltration, and increased expression of cytokines, which results in the formation of inflamed plaque affecting the skin, scalp, nails, and joints [1]
Biochemical data including serum glucose, LDL-cholesterol, and triglyceride levels were not significantly different between groups, but highsensitivity C-reactive protein (hsCRP) levels were significantly higher in patients with psoriasis compared to controls (1.3 ± 0.3 versus 0.3 ± 0.3, P = 0.001)
Pmax and P-wave dispersion (PWD) were significantly higher in group 1 than in group 2 (112.6 ± 22.7 versus 93.0 ± 12.8 ms, P < 0.001; 69.1 ± 22.6 versus 45.6 ± 19.4 ms, P < 0.001, respectively) (Table IV)
Summary
Psoriasis vulgaris is one of the most prevalent T-cellmediated, chronic, multisystemic, inflammatory diseases and is characterized by epidermal hyperproliferation, abnormal keratinocyte differentiation, T-lymphocyte infiltration, and increased expression of cytokines, which results in the formation of inflamed plaque affecting the skin, scalp, nails, and joints [1]. The pathogenesis of psoriasis is still not fully understood, systemic inflammatory response and oxidative stress are considered the most important mechanisms in the disease’s development. Some factors such as infection, drugs, trauma, alcohol consumption, smoking, cold weather, sunlight deprivation, and emotional stress have been acknowledged as triggering and/or aggravating the disease [2].
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