Peripheral vascular functional impairment as determined by Reactive hyperemia index associates with central functional impairment as determined by Aortic Distensibility beyond traditional cardiovascular risk factors

Authors

• AK Dey
• SR Sakhardande
• A Chaturvedi
• JB Lerman
• TM Aberra
• AA Joshi
• P Shukla
• MT Kabbany
• JI Silverman
• HL Teague
• Q Ng
• TZ Aridi
• MP Playford
• NN Mehta

Abstract

Psoriasis is a chronic inflammatory skin disease associated with increased cardiovascular risk, endothelial cell damage, and impaired vascular function. However, the relationship between peripheral and central vascular functional impairment, as determined by Reactive Hyperemia Index (RHI) and Aortic Distensibility, respectively, is unknown in psoriasis.Psoriasis patients received whole body MRI scans (n=98). Aortic wall thickness and distensibility were measured with phase contrast MRI [Medis]. Arterial tonometry was used to quantify RHI.Psoriasis patients were middle-aged, and slightly female predominant. The group was at low cardiovascular risk by Framingham score, however had significant cardiometabolic dysfunction. Reactive Hyperemia Index (RHI) was impaired in psoriasis, compared to previously published control populations. Aortic Distensibility was low (Median 0.62, IQR 0.48-0.97), and wall thickness was high (Median 3.97, IQR 3.62-4.49). To characterize the relationship between central and peripheral vascular impairment, we carried out an unadjusted and adjusted multivariable regression analysis between Aortic Distensibility and RHI. In this analysis, we discovered a direct relationship between Aortic Distensibility and RHI (Unadjusted beta=0.18, p=0.02) that persisted beyond adjustment for traditional cardiovascular risk factors (age, sex, FRS and BMI) (fully adjusted beta=0.20, p=0.005).Based on our results, we conclude that peripheral and central vascular functional impairment as determined by RHI and Aortic Distensibility, respectively, are associated with each other beyond traditional cardiovascular risk factors. Larger longitudinal studies are needed to confirm these findings.

Scientific Focus Area: Epidemiology

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