Psoriasis is associated with cardiovascular diseases (CVD). The purpose of this study was to evaluate the relationship between Left Ventricular (LV) asynchrony and psoriasis. Asynchrony was assessed in 31 patients with psoriasis without evidence of CVD and 25 healthy subjects. All the patients and controls were subjected to tissue synchronization imaging (TSI), and conventional and tissue Doppler echocardiography. The time to regional peak systolic tissue velocity (Ts) in LV by the six-basal-six-midsegmental model was measured on ejection phase TSI images, and four TSI parameters of systolic asynchrony were computed. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels in psoriatic patients were measured. All TSI parameters of LV asynchrony increased in psoriatic patients compared to the controls: the standard deviation (SD) of the 12 LV segments Ts (37.3 +/- 14.8 vs. 24.6 +/- 11.1, P=0.002); the maximal difference in Ts between any two of the 12 LV segments (112.7 +/- 39.8 vs. 83.1 +/- 38.1, P=0.01), the SD of the six basal LV segments (36.2 +/- 17.3 vs. 23.2 +/- 14.5, P=0.008); and the maximal difference in Ts between any two of the six basal LV segments (91.3 +/- 43.5 vs. 60.5 +/- 37.3, P=0.01). LV asynchrony was observed in 67.7% of psoriatic patients. Higher CRP (1.9 +/- 1.3 vs. 0.92 +/- 1.4, P=0.04) and ESR (34.8 +/- 17.3 vs. 20 +/- 15.3, P=0.03) levels were determined in patients with LV asynchrony. Regression analysis showed LV systolic asynchrony (P=0.02), Tei index (P=0.03), EF (P=0.04), and E/A ratio (P=0.04) were independently associated with psoriasis. LV asynchrony firstly described in patients with psoriasis may be an important finding of cardiac involvement in psoriasis.