Assessment of Electrocardiographic P Wave Dispersion in Individuals with and without Psoriasis: A Cross-sectional Study

Abstract

Introduction: Psoriasis is a prevalent, long-lasting inflammatory skin condition characterised by various clinical manifestations and arising from the interaction of genetic, environmental, and immunological factors. It has been found to be associated with several medical conditions, such as hypertension, diabetes, Cardiovascular (CV) diseases, and metabolic syndrome. Aim: To compare the Electrocardiographic P Wave Dispersion (PWD) in individuals with and without psoriasis and to correlate PWD with the Psoriasis Area Severity Index (PASI) score. Materials and Methods: This was a hospital-based cross-sectional study comparing the electrocardiographic PWD in 30 patients with psoriasis to that of 30 age- and gender-matched subjects without psoriasis who attended Government Medical College, Trivandrum, Kerala, India, during a period of one year (February 2021 to January 2022). A structured questionnaire was used to record history and examination findings. A 12-lead Electrocardiogram (ECG) was performed on study participants from both groups in a supine position following 15 minutes of rest. Categorical and quantitative variables were expressed as frequency (percentage) and mean±SD, respectively. The Karl Pearson test was used to find correlations. A p-value of ≤0.05 was considered statistically significant. Results: Ten (33.3%) patients belonged to the age group of 41-50 years. The duration of the disease ranged from six months to 21 years. Seventeen (56.7%) patients had a PASI score between 10-20, and 5 (16.7%) patients had a PASI score of less than 10. The maximum value of the P wave and PWD was higher in the case group and was statistically significant (p≤0.001 and p≤0.001, respectively). A statistically significant correlation was found between the severity of psoriasis and PWD (r=0.564, p≤0.001) and between the duration of psoriasis and PWD (r=0.372, p=0.04) in this study. Conclusion: PWD was found to be higher in psoriasis patients, with a significant correlation between PWD and both the severity and duration of the disease. Therefore, ECG should be considered as a screening test for Atrial Fibrillation (AF) in all psoriasis patients.

Keywords

• atrial fibrillation
• cardiovascular diseases
• psoriasis area severity index score