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

Abstract

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.

Microvascular and Endothelial Dysfunction in Prediabetes

“…Microvascular responsiveness can be assessed using various stimuli, such as iontophoresis with acetylcholine or post-ischemic forearm skin reactive hyperaemia, which is the most commonly used. The first studies included mainly patients with rheumatic diseases [ 97 , 98 , 99 , 100 , 101 ]; nevertheless, in recent years, it has been applied in patients with CVDs [ 102 , 103 ].…”

The importance of microvascular inflammation in ageing and age-related diseases: a position paper from the ESH working group on small arteries, section of microvascular inflammation

“…Subclinical microvascular alterations in psoriatic disease, inflammatory bowel disease, vasculitis and AS have also been studied [312][313][314]. Psoriatic patients and patients with inflammatory bowel disease present coronary microcirculatory dysfunction, as assessed by CFR, reduced endothelial glycocalyx thickness and microvascular perfusion impairment leading to impaired cardiac function (Figure 4, Supplemental Digital Content, http://links.lww.com/HJH/ C223) [27,28,[315][316][317][318].…”

Advances in Dynamic Light Scattering Imaging of Blood Flow

“…Mirdell et al demonstrated that LSCI can be effectively used as a supportive tool for monitoring and assessment of burn healing process, [208] assessment of scald wound healing [200,209] and prediction of psoriasis lesions expansion. [210,211] LSCI allows prediction accurately surgical need in scald burns, especially in a short period after injury study. [209] Compared to conventional LDF imaging, LSCI is faster and less sensitive to motion artifacts technique.…”