Current understanding and future perspectives of brain–heart–kidney axis in psoriatic arthritis

George Markousis-Mavrogenis, Michael T. Nurmohamed, Loukia Koutsogeorgopoulou, Theodoros Dimitroulas, Gikas Katsifis, Vasiliki Vartela, Dimos Mitsikostas, Genovefa Kolovou, Maria Tektonidou, Paraskevi Voulgari, Petros P. Sfikakis, George D. Kitas, Sophie I. Mavrogeni

Research output: Contribution to journalReview articleAcademicpeer-review


Psoriatic arthritis (PsA) patients are at a higher risk of systemic inflammatory sequelae, leading to microalbuminuria, cardiovascular (CVD) and neuropsychiatric (NPD) disease. Our aim is to present the existing literature about the relationship between CVD, kidney and NPD in PsA. The literature evaluation of PsA revealed that chronic T-cell activation and increased levels of circulating immune complexes can cause glomerular injury leading to microalbuminuria, which predicts CVD and all-cause mortality in both diabetic and non-diabetic patients. Furthermore, it is a marker of preclinical brain damage and identifies patients at higher risk of NPD/CVD events. Among the currently used imaging modalities in PsA, magnetic resonance imaging (MRI) maintains a crucial role, because it is ideal for concurrent evaluation of brain/heart involvement and serial follow up assessment. There is increasing evidence regarding the relationship between kidneys, heart and brain in PsA. Although currently there are no official recommendations about a combined brain/heart MRI in PsA, it could be considered in PsA with microalbuminuria, arrhythmia, HF, cognitive dysfunction and/or depression.

Original languageEnglish
Pages (from-to)1361-1368
Number of pages8
JournalRheumatology international
Issue number9
Publication statusPublished - 1 Sept 2020


  • Arrhythmia
  • Cardiovascular disease
  • Cardiovascular magnetic resonance imaging
  • Central nervous system disease
  • Central nervous system magnetic resonance imaging
  • Cognitive dysfunction
  • Depression
  • Heart failure
  • Psoriatric arthritis

Cite this