Abstract 589: Amygdala Activity Assessed by 18-FDG PET/CT Associates with Coronary Plaque Burden Quantified by Coronary Computed Tomography Angiography in Psoriasis

Psoriasis (PSO), a chronic inflammatory disease associated with increased prevalence of both stress and coronary artery disease, provides a model to study the role of perceived stress in cardiovascular (CV) disease. While stress perception quantified as resting amygdala activity (RAA) is associated with CV events, its association psoriasis severity as well subclinical CV indices is not well known. We thus, sought to look into the relationship between RAA, psoriasis area severity index (PASI) score and Non-calcified burden (NCB) in PSO. 150 consecutive PSO patients and 58 healthy volunteers (HV) underwent 18-FDG PET/CT and CCTA scans (Toshiba, 320-detector row) to quantify RAA and NCB respectively. Skin disease severity was assessed as PASI score, RAA as target-to-background ratio (Osirix) and NCB using prior published methods (QAngio). The relationship between them was analyzed using multivariable regressions (STATA 12). Despite older age, both PSO & HV were at low CV risk by traditional risk score. RAA was higher in PSO compared to HV (Table 1). Moreover, PASI score correlated positively with RAA in treatment naïve psoriasis patients (β=0.22, p=0.03). Furthermore, RAA associated with NCB (β=0.27, p<0.001), which persisted independent of traditional risk factors (β=0.19, p<0.001). Similar relationship was not observed in HV. In conclusion, PSO skin disease severity relates to amygdalar activity by 18-FDG PET/CT suggesting the role of chronic inflammatory disease like PSO in triggering perceived psychological stress. Moreover, there is a direct association between amygdalar activity and coronary plaque burden suggesting a role for perceived stress in subclinical CV disease in these patients. Larger studies are needed to confirm these findings.

Duke Scholars

Author Joseph Buckley Lerman Medicine, Cardiology