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Coronary Artery Disease II: Pathophysiology01:26

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Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
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Peripheral Artery Disease I: Introduction01:30

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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
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Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
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Psychoneuroimmunology (PNI) is a multidisciplinary field that examines how psychological factors, particularly stress, interact with the immune system and impact physical health. Research in PNI has shown that chronic or traumatic stress can disrupt both the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. These disruptions contribute to serious health conditions, including cardiovascular diseases.
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Coronary microvascular dysfunction in patients with psoriasis.

Brittany Weber1, Lourdes M Perez-Chada2, Sanjay Divakaran1

  • 1Cardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Boston, USA.

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|May 19, 2020
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Summary

Patients with psoriasis have a higher prevalence of coronary microvascular dysfunction (CMD) than controls. This dysfunction is not fully explained by traditional cardiovascular risk factors or atherosclerosis burden.

Keywords:
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Area of Science:

  • Cardiology
  • Dermatology
  • Inflammation Research

Background:

  • Psoriasis is a chronic inflammatory skin condition linked to increased cardiovascular risk.
  • The role of inflammation in psoriasis-associated cardiometabolic issues is significant but understudied.
  • This study examines coronary microvascular dysfunction (CMD) in psoriasis patients.

Purpose of the Study:

  • To investigate the prevalence and severity of CMD in psoriasis patients.
  • To determine if CMD in psoriasis is linked to cardiovascular risk factors and atherosclerotic burden.
  • To understand the underlying mechanisms of excess cardiovascular risk in psoriasis.

Main Methods:

  • Retrospective cohort study comparing 62 psoriasis patients with 112 controls.
  • Positron Emission Tomography (PET) imaging used to quantify myocardial perfusion and myocardial flow reserve (MFR).
  • Coronary artery disease (CAD) assessed via computed tomography (CT) coronary calcium scoring.

Main Results:

  • Prevalence of CMD (MFR < 2) was significantly higher in psoriasis patients (61.3%) versus controls (38.4%).
  • Psoriasis patients showed a more severe reduction in adjusted MFR.
  • Atherosclerotic burden, measured by calcium score, was similar between groups.

Conclusions:

  • Psoriasis patients without overt coronary artery disease (CAD) exhibit a high prevalence of coronary vasomotor abnormalities.
  • These abnormalities are not fully explained by common cardiovascular risk factors or the extent of atherosclerosis.
  • Further research is needed to elucidate the mechanisms driving CMD in psoriasis.