Electrical instability of the myocardium in patients with arterial hypertension depending on the severity of concomitant psoriasis

Abstract

Background. Currently, psoriasis is the most common skin disease, its prevalence reaches 5% and this pathology often occurs together with arterial hypertension. Both arterial hypertension and psoriasis contribute to the remodeling of the cardiovascular system. As is known, myocardial remodeling is a substrate for electrical instability of the myocardium.
Objective. The aim of the study was to study the parameters of the signal-averaged electrocardiogram in men with stage 2 arterial hypertension with concomitant vulgar psoriasis in the progressive stage, and to evaluate the parameters of the signal-averaged electrocardiogram against the background of psoriasis therapy. A total of 86 men with stage 2 arterial hypertension with a progressive stage of vulgar psoriasis with a severe and moderate course were examined. Signal-averaged ECG was recorded before psoriasis therapy was prescribed and after 6 months of systemic and topical psoriasis therapy.
Results. A statistically significant moderate positive correlation was found between the severity of psoriasis vulgaris (according to the PASI index) and such an SU-ECG indicator as the duration of the filtered QRS complex (r = 0.32; p = 0.005), a statistically significant weak negative correlation of the PASI index with the root-mean-square amplitude of the last 40 ms of the filtered QRS complex (r = -0.27; p = 0.012). Patients with severe psoriasis had more pronounced changes in cardiac electrophysiology, in the form of more frequent recording of late ventricular potentials χ2 = 4.07; p = 0.044, a longer duration of the filtered QRS complex (p = 0.01). Systemic and topical therapy of concomitant psoriasis in patients with arterial hypertension leads to a decrease in the frequency of recording late ventricular potentials, and in patients who had severe psoriasis before the start of treatment, late potentials were recorded significantly more often after 6 months of therapy (χ2 = 3.88; p = 0.049) than in patients with initially moderate-severe psoriasis.