Cardiovascular Imaging in Psoriasis: A Critical Review of Current Evidence, Techniques, and Therapeutic Implications

Kurd SK, Gelfand JM. The prevalence of previously diagnosed and undiagnosed psoriasis in US adults: results from NHANES 2003-2004. J Am Acad Dermatol. 2009;60:218–24. https://doi.org/10.1016/j.jaad.2008.09.022.

Article  PubMed  Google Scholar 

Garshick MS, Ward NL, Krueger JG, Berger JS. Cardiovascular risk in patients with psoriasis. J Am Coll Cardiol. 2021;77:1670–80. https://doi.org/10.1016/j.jacc.2021.02.009.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Armstrong EJ, Harskamp CT, Armstrong AW. Psoriasis and major adverse cardiovascular events: a systematic review and meta‐analysis of observational studies. J Am Heart Assoc. 2013;2:e000062. https://doi.org/10.1161/JAHA.113.000062.

Article  PubMed  PubMed Central  Google Scholar 

Armstrong AW, Voyles SV, Armstrong EJ, Fuller EN, Rutledge JC. A tale of two plaques: convergent mechanisms of T-cell-mediated inflammation in psoriasis and atherosclerosis. Exp Dermatol. 2011;20:544–9. https://doi.org/10.1111/j.1600-0625.2011.01308.x.

Article  CAS  PubMed  Google Scholar 

Lockshin B, Balagula Y, Merola JF. Interleukin 17, inflammation, and cardiovascular risk in patients with psoriasis. J Am Acad Dermatol. 2018;79:345–52. https://doi.org/10.1016/j.jaad.2018.02.040.

Article  CAS  PubMed  Google Scholar 

Yang K, Liu Q, Fan A, Lin H, Wang X, Cui T, et al. Th17 cells in cardiovascular disease. Cell Biochem Funct. 2025;43:e70069. https://doi.org/10.1002/cbf.70069.

Article  CAS  PubMed  Google Scholar 

Boehncke W-H, Boehncke S, Tobin A-M, Kirby B. The «psoriatic march»: a concept of how severe psoriasis may drive cardiovascular comorbidity. Exp Dermatol. 2011;20:303–7. https://doi.org/10.1111/j.1600-0625.2011.01261.x.

Article  PubMed  Google Scholar 

Elnabawi YA, Dey AK, Goyal A, Groenendyk JW, Chung JH, Belur AD, et al. Coronary artery plaque characteristics and treatment with biologic therapy in severe psoriasis: results from a prospective observational study. Cardiovasc Res. 2019;115:721–8. https://doi.org/10.1093/cvr/cvz009.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Bao W, Yang M, Xu Z, Yan F, Yang Q, Li X, et al. Coronary inflammation assessed by perivascular fat attenuation index in patients with psoriasis: a propensity score-matched study. Dermatology. 2022;238:562–70. https://doi.org/10.1159/000518771.

Article  CAS  PubMed  Google Scholar 

Piaserico S, Osto E, Famoso G, Montisci R, De Michieli L, Zanetti I, et al. Long-term prognostic value of coronary flow reserve in psoriasis patients. Atherosclerosis. 2019;289:57–63. https://doi.org/10.1016/j.atherosclerosis.2019.08.009.

Article  CAS  PubMed  Google Scholar 

Gröschel J, Grassow L, Blaszczyk E, Lommel K, Kokolakis G, Sabat R, et al. Deep cardiac phenotyping by cardiovascular magnetic resonance reveals subclinical focal and diffuse myocardial injury in patients with psoriasis (PSOR-COR study). Clin Res Cardiol. 2024. https://doi.org/10.1007/s00392-024-02456-9.

Article  PubMed  PubMed Central  Google Scholar 

Seremet S, Genc B, Tastan A, Akyildiz ZI, Nazli C, Ozcelik S, et al. Are all patients with psoriasis at increased risk for coronary artery disease? Int J Dermatol. 2015;54:355–61. https://doi.org/10.1111/ijd.12673.

Article  PubMed  Google Scholar 

Osto E, Piaserico S, Maddalozzo A, Forchetti G, Montisci R, Famoso G, et al. Impaired coronary flow reserve in young patients affected by severe psoriasis. Atherosclerosis. 2012;221:113–7. https://doi.org/10.1016/j.atherosclerosis.2011.12.015.

Article  CAS  PubMed  Google Scholar 

Tona F, Osto E, Kerkhof PLM, Montisci R, Famoso G, Lorenzoni G, et al. Multiparametric analysis of coronary flow in psoriasis using a coronary flow reserve companion. Eur J Clin Invest. 2022;52:e13711. https://doi.org/10.1111/eci.13711.

Article  CAS  PubMed  Google Scholar 

Kaiser H, Kvist-Hansen A, Krakauer M, Gørtz PM, Henningsen KMA, Wang X, et al. Statin therapy and vascular inflammation detected by positron emission tomography/computed tomography in patients with psoriasis. Acta Derm Venereol. 2021;101:adv00406. https://doi.org/10.2340/00015555-3752.

Article  PubMed  Google Scholar 

Green R, Cantoni V, Acampa W, Assante R, Zampella E, Nappi C, et al. Prognostic value of coronary flow reserve in patients with suspected or known coronary artery disease referred to PET myocardial perfusion imaging: a meta-analysis. J Nucl Cardiol. 2021;28:904–18. https://doi.org/10.1007/s12350-019-02000-7.

Article  PubMed  Google Scholar 

Levy BI, Heusch G, Camici PG. The many faces of myocardial ischaemia and angina. Cardiovasc Res. 2019;115:1460–70. https://doi.org/10.1093/cvr/cvz160.

Article  CAS  PubMed  Google Scholar 

Taqueti VR, Everett BM, Murthy VL, Gaber M, Foster CR, Hainer J, et al. Interaction of impaired coronary flow reserve and cardiomyocyte injury on adverse cardiovascular outcomes in patients without overt coronary artery disease. Circulation. 2015;131:528–35. https://doi.org/10.1161/CIRCULATIONAHA.114.009716.

Article  CAS  PubMed  Google Scholar 

Britten MB, Zeiher AM, Schächinger V. Microvascular dysfunction in angiographically normal or mildly diseased coronary arteries predicts adverse cardiovascular long-term outcome. Coron Artery Dis. 2004;15:259. https://doi.org/10.1097/01.mca.0000134590.99841.81.

Article  PubMed  Google Scholar 

Ikonomidis I, Makavos G, Papadavid E, Varoudi M, Andreadou I, Gravanis K, et al. Similarities in coronary function and myocardial deformation between psoriasis and coronary artery disease: the role of oxidative stress and inflammation. Can J Cardiol. 2015;31:287–95. https://doi.org/10.1016/j.cjca.2014.11.002.

Article  PubMed  Google Scholar 

Ikonomidis I, Pavlidis G, Katogiannis K, Kapniari I, Theodoropoulos K, Kountouri A, et al. Differences in coronary flow reserve and flow-mediated dilation between plaque psoriasis and psoriatic arthritis. Eur Heart J. 2022;43:ehac544.2643. https://doi.org/10.1093/eurheartj/ehac544.2643.

Article  Google Scholar 

Fioranelli M, Roccia MG, Lotti T. Coronary blood flow and psoriasis. Dermatol Ther. 2017. https://doi.org/10.1111/dth.12471.

Article  PubMed  Google Scholar 

Piaserico S, Osto E, Famoso G, Zanetti I, Gregori D, Poretto A, et al. Treatment with tumor necrosis factor inhibitors restores coronary microvascular function in young patients with severe psoriasis. Atherosclerosis. 2016;251:25–30. https://doi.org/10.1016/j.atherosclerosis.2016.05.036.

Article  CAS  PubMed  Google Scholar 

Piaserico S, Papadavid E, Cecere A, Orlando G, Theodoropoulos K, Katsimbri P, et al. Coronary microvascular dysfunction in asymptomatic patients with severe psoriasis. J Invest Dermatol. 2023;143:1929-1936.e2. https://doi.org/10.1016/j.jid.2023.02.037.

Article  CAS  PubMed  Google Scholar 

Jain H, Tariq MD, Khan AM, Ahsan A, Zulfiqar E, Shahnoor S, et al. Assessment of subclinical atherosclerosis in patients with psoriasis using echocardiographic coronary flow reserve parameters: a systematic review and meta-analysis. Br J Hosp Med. 2025;86(2):1–16. https://doi.org/10.12968/hmed.2024.0618.

Article  Google Scholar 

Taqueti VR, Hachamovitch R, Murthy VL, Naya M, Foster CR, Hainer J, et al. Global coronary flow reserve associates with adverse cardiovascular events independently of luminal angiographic severity, and modifies the effect of early revascularization. Circulation. 2015;131:19–27. https://doi.org/10.1161/CIRCULATIONAHA.114.011939.

Article  PubMed  Google Scholar 

Gullu H, Caliskan M, Dursun R, Ciftci O, Guven A, Muderrisoglu H. Impaired coronary microvascular function and its association with disease duration and inflammation in patients with psoriasis. Echocardiography. 2013;30:912–8. https://doi.org/10.1111/echo.12156.

Article  PubMed  Google Scholar 

Milaniuk S, Pietrzak A, Mosiewicz B, Mosiewicz J, Reich K. Influence of psoriasis on circulatory system function assessed in echocardiography. Arch Dermatol Res. 2015;307:855–61. https://doi.org/10.1007/s00403-015-1586-7.

Article  PubMed  PubMed Central  Google Scholar 

Gorga E, Scodro M, Valentini F, D’Ortona R, Arisi M, Sciatti E, et al. Echocardiographic evaluation of diastolic dysfunction in young and healthy patients with psoriasis: a case–control study. Monaldi Arch Chest Dis Arch Monaldi Mal Torace. 2018;88:934.

Comments (0)

No login
gif