Abstract 12605: Brain Metabolic Activity Within Regions Involved in Stress Perception Associates Directly With Arterial Inflammation and Inversely With Aortic Distensibility in Psoriasis
Introduction: Psychological stress and depression are linked to increased cardiovascular (CV) events in the general population and in psoriasis (PSO), a chronic inflammatory disease that increases CV risk. 18-FDG-PET/CT enables quantification of metabolic activity of the amygdala, a neural tissue critically involved in the pathobiology of stress and depression. In individuals without chronic inflammatory diseases, amygdalar activity (AmygAct) associates with greater vascular inflammation (VI) and CV events. However, it is not known whether PSO maintains this relationship with VI and whether AmygAct associates with other measures of subclinical CVD.
Hypothesis: In PSO, AmygAct: 1) is higher in individuals who report depression/anxiety, and 2) associates with greater VI and decreased aortic distensibility.
Methods: Subjects with PSO (n=82) completed a questionnaire at baseline, reporting psychiatric history and were placed into two groups accordingly: patients with depression/anxiety and age and sex matched controls with no psychiatric diagnoses. AmygAct was quantified using 18-FDG PET/CT by an analyst blinded to clinical data. Mean standardized uptake values (SUV) for the left amygdala were corrected for background brain activity. VI was quantified as a ratio of aortic to blood background SUV. Aortic distensibility was measured using phase contrast MRI.
Results: Subjects had a mean age of 49.2 years, were 49% males, and had a median Framingham risk score of 3. Patients with a history of depression and/or anxiety had significantly higher AmygAct than those without (mean±SEM 0.85±0.01 vs. 0.81±0.01; p=0.01). AmygAct correlated with VI (β= 0.26, p=0.02) as well as aortic distensibility (β= -0.50, p<0.001). Moreover, AmygAct remained associated with aortic distensibility after adjustment for Framingham risk score and hypertension (β= -0.37, p=0.007).
Conclusions: Metabolic activity within neural tissues involved in stress perception significantly associates with indices of atherosclerotic disease in PSO. Future studies should further evaluate the mechanisms linking neural and atherosclerotic tissues in chronic inflammatory conditions such as PSO, and probe whether perturbing this mechanism may reduce the burden of atherosclerosis.
- Subclinical atherosclerosis
- Cardiovascular imaging
- Cardiovascular disease prevention
Author Disclosures: T.M. Aberra: None. A. Chaturvedi: None. J.B. Lerman: None. A.K. Dey: None. P. Shukla: None. A.A. Joshi: None. J.A. Rodante: None. J.I. Silverman: None. Q. Ng: None. H.L. Teague: None. M.A. Ahlman: None. D.A. Bluemke: None. M.P. Playford: None. A.A. Tawakol: None. N.N. Mehta: None.
- © 2016 by American Heart Association, Inc.