Right Ventricular Strain in Detecting Subclinical Right Ventricular Systolic Dysfunction in Psoriatic Arthritis Patients: Relation to Serum Endostatin Level

Inclusion Criteria: * Psoriatic arthritis patients according to CASPAR criteria * Psoriatic arthritis patients without overt cardiovascular symptoms * Patients with age between 20 to 50 years of age Exclusion Criteria: * Other systemic autoimmune diseases * Patients with a history of known valvular disease, atrial fibrillation or any other arrhythmia , heart failure, ischemic cardiomyopathy severe obstructive pulmonary diseases and metabolic syndrome. * Patients with medical disorders as renal, congenital heart diseases, hematological disorders and cancer patients. * Patients taking certain drugs that have been confirmed to be risk factors for PAH such as appetite suppressant intake drugs (aminorex, fenfluramine derivatives and benfluorex) and chemotherapeutic agents. * Family history of myocardial infarction, cerebrovascular disease or sudden death before the age of 65y in females and 55 y in males.