Heart rate variability and turbulence analysis in patients with psoriasis

Öz

Objectives: Psoriasis vulgaris (PV) is a chronic inflam­matory skin disorder with increased incidence of many systemic abnormalities. However, the effects of psoria­sis on autonomic nervous system have not been previ­ously well-defined. Impaired autonomic function with an increase in sympathetic activity may be associated with ventricular arrhythmias and sudden cardiac death in the general population. Heart rate turbulence (HRT) is a non­invasive test to reflect the increased sympathetic tone and abnormal baroreflex sensitivity. The aim of current study was to investigate the effect of psoriasis on cardiac au­tonomic function by using HRT and heart rate variability (HRV) parameters as possible indicators of increased risk for ventricular arrhythmias and sudden cardiac death. Materials and methods: The study comprised 20 pso­riatic patients without cardiovascular involvement and age and sex matched 20 healthy subjects. The severity of the disease was evaluated by the “Psoriasis Area and Severity Index”. The HRV and turbulence analysis were assessed from a 24-hour Holter recording. Results: There were no statistically significant differenc­es between the two groups with respect to clinical, de­mographic and biochemical characteristics. When HRT parameters were compared; the values of the turbulence onset and slope in psoriatic patients were not significantly different from the control group (p>0.05). HRV parame­ters except for high frequency power (significantly lower in psoriatic patients, p0.05). Conclusion: Psoriasis appeared not to be associated with impaired autonomic function regarding to HRT and HRV values. Further investigations are needed to confirm these results.

Anahtar Kelimeler

• Heart rate variability; psoriasis; turbulence analysis.

Psöriazisli hastalarda kalp hızı değişkenliği ve türbülans analizi

Öz

Amaç: Psöriasis Vulgaris (PV), çok sayıda sistemik has­talık insidansının arttığı gösterilen bir kronik yangısal deri hastalığıdır. Ancak PV\'in otonom sinir sistemi üzerine olan etkisi iyi tanımlanmamıştır. Artmış sempatik aktivite ile seyreden bozulmuş otonomik işlev bozukluğu, genel populasyonda ani kalp ölümü ve ventriküler aritmilerle ilişkilidir. Kalp Hızı Türbülansı (KHT), anormal barorefleks duyarlılığını ve artmış sempatik tonusu gösteren invaziv olmayan bir testtir. Bu çalışmanın amacı; artmış ventrikü­ler aritmi ve ani kardiyak ölüm riskinin muhtemel göster­geleri olan KHT ve kalp hızı değişkenliği (KHD) paramet­relerini kullanarak, PV\'nin kardiyak otonomik fonksiyon üzerine olan etkisini saptamaktır. Gereç ve yöntem: Çalışmaya kardiyovasküler tutulumu olmayan 20 psöriatik hasta ve yaş-cinsiyet yönünden benzer 20 sağlıklı birey dahil edildi. Hastalık ciddiyeti, “Psöriasis Alan Şiddet İndeksi” kullanılarak değerlendiril­di. KHD ve türbülans analizi, 24 saat-Holter kayıtları ile elde edildi. Bulgular: İki grup arasında, klinik, demografik ve biyo­kimyasal karakteristikler açısından istatistiksel anlamlı farklılık yoktu (p>0.05). KHT parametreleri karşılaştırıl­dığında, psöriatik hastalarda turbulans onset ve slop de­ğerleri kontrol grubundan farklı değildi (p>0.05). Yüksek frekans gücü haricinde (psöriatik hastalarda daha düşük, p0.05). Sonuç: KHD ve KHT değerleri açısından, PV bozulmuş otonomik fonksiyon ile ilişkili gözükmemektedir. Bu so­nuçları doğrulayacak daha ileri araştırmalar gereklidir.

Anahtar Kelimeler

• Kalp hızı değişkenliği, psöriazis, tür­bülans analizi

Kaynakça

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