Blunted Microvascular Reactivity in Psoriasis Patients in the Absence of Cardiovascular Disease, as Assessed by Laser Speckle Contrast Imaging

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Anastasia Margouta1, Panagiota Anyfanti1,2, Αntonios Lazaridis1, Barbara Nikolaidou1, Κonstantinos Mastrogiannis1, Anastasia Malliora1, Aikaterini Patsatsi3, Αreti Triantafyllou1, Στέλλα Δούμα1, Michael Doumas4, Εugenia Gkaliagkousi1
13rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece
2Second Medical Department, Hippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
32nd Department of Dermatology and Venereology, Papageorgiou General Hospital, Medical School Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece
42nd Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece

Tóm tắt

Psoriasis is associated with accelerated rates of cardiovascular disease (CVD). Laser Speckle Contrast Imaging (LSCI) is a novel, non-interventional technique for the dynamic assessment of microvascular endothelial dysfunction, which represents an early precursor of CVD. We investigated whether skin microvascular reactivity is impaired in psoriasis and whether an association exists with large artery stiffening. Skin microvascular reactivity was assessed with LSCI combined with post-occlusive reactive hyperaemia protocol in psoriasis patients and controls in the absence of established CVD. Arterial stiffness and central hemodynamics were assessed throughout a whole 24 h period with the Mobil-O-Graph device. Most LSCI indices of microvascular reactivity were impaired in psoriasis patients (n = 90) compared to controls (n = 45) [baseline flux; occlusion flux; peak-to-baseline magnitude; baseline cutaneous vascular conductance (CVC); percentage increase in CVC, p < 0.001 for all comparisons]. In multivariate analysis, psoriatic disease predicted the above markers independently of classical CVD risk factors. Augmentation index, peripheral pulse pressure, and central systolic/diastolic blood pressure correlated with LSCI microvascular responses in the study population (n = 135). Pulse wave velocity significantly correlated with nearly all LSCI parameters, while the association with baseline flux was independent of CVD risk factors and psoriatic disease in multivariate analysis (beta = 0.096, p = 0.039). This study provides evidence of altered skin microvascular responses in psoriasis by use of LSCI, and interaction with macrovascular dysfunction, before the establishment of overt CVD. A non-interventional approach of skin microcirculation with LSCI might be used as an early indicator of vascular health in psoriasis.

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Tài liệu tham khảo

Masson, 2020, Psoriasis and Cardiovascular Risk: A Comprehensive Review, Adv. Ther., 37, 2017, 10.1007/s12325-020-01346-6

Puig, L. (2017). Cardiometabolic Comorbidities in Psoriasis and Psoriatic Arthritis. Int. J. Mol. Sci., 19.

Pietrzak, 2013, Cardiovascular aspects of psoriasis: An updated review, Int. J. Dermatol., 52, 153, 10.1111/j.1365-4632.2012.05584.x

Anyfanti, 2020, Endothelial Dysfunction in Patients with Rheumatoid Arthritis: The Role of Hypertension, Curr. Hypertens. Rep., 22, 56, 10.1007/s11906-020-01064-y

Vlachopoulos, 2010, Prediction of cardiovascular events and all-cause mortality with arterial stiffness: A systematic review and meta-analysis, J. Am. Coll. Cardiol., 55, 1318, 10.1016/j.jacc.2009.10.061

Vlachopoulos, 2010, Prediction of cardiovascular events and all-cause mortality with central haemodynamics: A systematic review and meta-analysis, Eur. Heart J., 31, 1865, 10.1093/eurheartj/ehq024

Triantafyllou, 2014, Accumulation of microvascular target organ damage in newly diagnosed hypertensive patients, J. Am. Soc. Hypertens., 8, 542, 10.1016/j.jash.2014.04.008

Nikolaidou, B., Gkaliagkousi, E., Anyfanti, P., Gavriilaki, E., Lazaridis, A., Triantafyllou, A., Zografou, I., and Douma, S. (2020). The impact of hyperglycemia on urinary albumin excretion in recent onset diabetes mellitus type II. BMC Nephrol., 21.

Alexandrou, 2021, Haemodialysis and peritoneal dialysis patients have severely impaired post-occlusive skin forearm vasodilatory response assessed with laser speckle contrast imaging, Clin. Kidney J., 14, 1419, 10.1093/ckj/sfaa136

Anyfanti, 2019, Noninvasive assessment of myocardial perfusion in different blood pressure phenotypes and its association with arterial stiffness indices, Am. J. Hypertens., 32, 557, 10.1093/ajh/hpz039

Koletsos, 2021, Skin microvascular dysfunction in patients with systemic lupus erythematosus with and without cardiovascular risk factors, Rheumatology, 60, 2834, 10.1093/rheumatology/keaa722

Anyfanti, 2018, Dermal capillary rarefaction as a marker of microvascular damage in patients with rheumatoid arthritis: Association with inflammation and disorders of the macrocirculation, Microcirculation, 25, e12451, 10.1111/micc.12451

Anyfanti, 2017, Retinal vessel morphology in rheumatoid arthritis: Association with systemic inflammation, subclinical atherosclerosis and cardiovascular risk, Microcirculation, 24, e12417, 10.1111/micc.12417

Anyfanti, 2017, Subendocardial viability ratio in patients with rheumatoid arthritis: Comparison with healthy controls and identification of prognostic factors, Clin. Rheumatol., 36, 1229, 10.1007/s10067-017-3659-9

Anyfanti, 2022, Endothelial Dysfunction in Psoriasis: An Updated Review, Front. Med., 9, 864185, 10.3389/fmed.2022.864185

Durand, 2012, Assessment of skin microvascular function and dysfunction with laser speckle contrast imaging, Circ. Cardiovasc. Imaging, 5, 155, 10.1161/CIRCIMAGING.111.970418

Roustit, 2013, Assessment of endothelial and neurovascular function in human skin microcirculation, Trends Pharmacol. Sci., 34, 373, 10.1016/j.tips.2013.05.007

Roustit, 2010, Excellent reproducibility of laser speckle contrast imaging to assess skin microvascular reactivity, Microvasc. Res., 80, 505, 10.1016/j.mvr.2010.05.012

Tew, 2011, Comparison of laser speckle contrast imaging with laser Doppler for assessing microvascular function, Microvasc. Res., 82, 326, 10.1016/j.mvr.2011.07.007

Souza, 2014, Impairment of systemic microvascular endothelial and smooth muscle function in individuals with early-onset coronary artery disease: Studies with laser speckle contrast imaging, Coron. Artery Dis., 25, 23, 10.1097/MCA.0000000000000055

Gkaliagkousi, E., Lazaridis, A., Anyfanti, P., Stavropoulos, K., Imprialos, K., Triantafyllou, A., Mastrogiannis, K., Douma, S., and Doumas, M. (2021). Assessment of skin microcirculation in primary aldosteronism: Impaired microvascular responses compared to essential hypertensives and normotensives. J. Hum. Hypertens.

Lazaridis, 2021, Skin microvascular function, as assessed with laser speckle contrast imaging, is impaired in untreated essential and masked hypertension, Hypertens. Res., 45, 445, 10.1038/s41440-021-00816-w

Ruaro, 2014, Laser speckle contrast analysis: A new method to evaluate peripheral blood perfusion in systemic sclerosis patients, Ann. Rheum. Dis., 73, 1181, 10.1136/annrheumdis-2013-203514

Williams, 2018, 2018 ESC/ESH Guidelines for the management of arterial hypertension, J. Hypertens., 36, 1953, 10.1097/HJH.0000000000001940

World Health Organization (WHO) (2011). Report and Consultation (WHO) WHO, Abbreviated report of a WHO consultation. Use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus. Diabetes Care, 33, 1–25.

Mach, 2019, 2019 ESC/EAS guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk, Atherosclerosis, 290, 140, 10.1016/j.atherosclerosis.2019.08.014

World Medical Association (2013). World Medical Association Declaration of Helsinki. JAMA, 310, 2191.

Boas, 2010, Laser speckle contrast imaging in biomedical optics, J. Biomed. Opt., 15, 011109, 10.1117/1.3285504

Senarathna, 2013, Laser Speckle Contrast Imaging: Theory, Instrumentation and Applications, IEEE Rev. Biomed. Eng., 6, 99, 10.1109/RBME.2013.2243140

Gavriilaki, 2022, A non-interventional study of microcirculation dynamics in allogeneic hematopoietic cell transplantation survivors compared to controls: Evidence of impaired microvascular response regardless of conventional cardiovascular risk factors, Bone Marrow Transplant., 57, 72, 10.1038/s41409-021-01500-w

Rousseau, 2011, Increasing the “region of interest” and “time of interest”, both reduce the variability of blood flow measurements using laser speckle contrast imaging, Microvasc. Res., 82, 88, 10.1016/j.mvr.2011.03.009

Sarafidis, 2014, Evaluation of a Novel Brachial Cuff-Based Oscillometric Method for Estimating Central Systolic Pressure in Hemodialysis Patients, Am. J. Nephrol., 40, 242, 10.1159/000367791

Hametner, 2013, Oscillometric estimation of aortic pulse wave velocity: Comparison with intra-aortic catheter measurements, Blood Press. Monit., 18, 173, 10.1097/MBP.0b013e3283614168

Weber, 2011, Validation of a brachial cuff-based method for estimating central systolic blood pressure, Hypertension, 58, 825, 10.1161/HYPERTENSIONAHA.111.176313

Anyfanti, 2022, Impaired skin microcirculation dynamics in patients with rheumatoid arthritis: Association with arterial stiffness and coronary microvascular perfusion, J Hypertens., 45, e51, 10.1097/01.hjh.0000835696.61506.de

Gkaliagkousi, 2015, Clinical Significance of Endothelial Dysfunction in Essential Hypertension, Curr. Hypertens. Rep., 17, 85, 10.1007/s11906-015-0596-3

Orlando, 2022, Psoriasis and Cardiovascular Diseases: An Immune-Mediated Cross Talk?, Front Immunol., 13, 868277, 10.3389/fimmu.2022.868277

Fang, 2016, Association Between Psoriasis and Subclinical Atherosclerosis: A Meta-Analysis, Medicine, 95, e3576, 10.1097/MD.0000000000003576

Dattola, 2022, Prevalence of Atherosclerosis in Psoriatic Patients Detected with Epiaortic Color Doppler Ultrasound and Computed Tomography Angiography, Dermatol Pract Concept., 12, e2022011, 10.5826/dpc.1201a11

Youn, 2015, Subclinical systemic and vascular inflammation detected by (18) F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with mild psoriasis, J. Dermatol., 42, 559, 10.1111/1346-8138.12859

Kaur, 2018, 18F-fluorodeoxyglucose positron emission tomography-based evaluation of systemic and vascular inflammation and assessment of the effect of systemic treatment on inflammation in patients with moderate-to-severe psoriasis: A randomized placebo-controlled pilot study, Indian J. Dermatol. Venereol. Leprol., 84, 660, 10.4103/ijdvl.IJDVL_717_17

Lacarrubba, 2015, Advances in non-invasive techniques as aids to the diagnosis and monitoring of therapeutic response in plaque psoriasis: A review, Int. J. Dermatol., 54, 626, 10.1111/ijd.12870

Alba, 2018, Endothelial function is impaired in the cutaneous microcirculation of adults with psoriasis through reductions in nitric oxide-dependent vasodilation, Am. J. Physiol. Heart Circ. Physiol., 314, H343, 10.1152/ajpheart.00446.2017

Gigante, 2021, Laser speckle contrast analysis predicts major vascular complications and mortality of patients with systemic sclerosis, Rheumatology, 60, 1850, 10.1093/rheumatology/keaa514

Di Battista, M., Da Rio, M., Logiacco, A., Barsotti, S., Della Rossa, A., and Mosca, M. (2022). Kinetics of response to iloprost evaluated by laser speckle contrast analysis in systemic sclerosis. Scand J Rheumatol., 1–4.

Rodrigues, 2007, Endothelial function in patients with type 1 diabetes evaluated by skin capillary recruitment, Microvasc. Res., 73, 107, 10.1016/j.mvr.2006.11.004

Liu, 2016, Relation between endothelial progenitor cells and arterial stiffness in patients with psoriasis, J. Dermatol., 43, 888, 10.1111/1346-8138.13235

Laurent, 2009, Large and small artery cross-talk and recent morbidity-mortality trials in hypertension, Hypertension, 54, 388, 10.1161/HYPERTENSIONAHA.109.133116

Triantafyllou, 2014, Association between retinal vessel caliber and arterial stiffness in a population comprised of normotensive to early-stage hypertensive individuals, Am. J. Hypertens., 27, 1472, 10.1093/ajh/hpu074