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The relationship between systemic inflammation and increased left ventricular mass is partly mediated by noncalcified

Wunan Zhou1, Meron Teklu1, Vy Bui1

  • 1National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States.

American Journal of Preventive Cardiology
|October 6, 2021
PubMed

Insights

Systemic inflammation and early coronary artery disease (noncalcified coronary burden) both contribute to increased left ventricular mass in psoriasis patients. Noncalcified coronary burden partially mediates the link between inflammation and left ventricular mass.

Area of Science:

  • Cardiology
  • Inflammation Research
  • Dermatology

Background:

  • Increased left ventricular (LV) mass is a significant precursor to heart failure.
  • Systemic inflammation plays a key role in the development of LV mass.
  • The specific contribution of subclinical coronary artery disease (CAD) to this inflammation-LV mass relationship remains unclear.

Purpose of the Study:

  • To investigate the association between systemic inflammation, measured by plasma glycoprotein A (GlycA), and LV mass in psoriasis patients.
  • To determine if early CAD, assessed as noncalcified coronary burden (NCB), mediates the relationship between GlycA and LV mass.
  • To evaluate the longitudinal association between changes in NCB and changes in LV mass.

Main Methods:

  • An observational longitudinal study involving 213 subjects with psoriasis and no known cardiovascular disease.
  • Measurements included plasma GlycA (nuclear magnetic resonance spectroscopy) and LV mass and NCB (coronary CT angiography).
  • 189 participants were followed for one year, with repeated measurements of LV mass and NCB.

Main Results:

  • LV mass significantly increased across tertiles of GlycA (p<0.001).
  • Both GlycA (β=0.24, p=0.001) and NCB (β=0.50, p<0.001) were independently associated with LV mass after adjusting for multiple risk factors.
  • Mediation analysis revealed that NCB accounted for 32% of the GlycA-LV mass association. Longitudinal analysis showed change in NCB independently predicted change in LV mass (β=0.25, p=0.002).

Conclusions:

  • Both systemic inflammation (GlycA) and coronary artery NCB are associated with LV mass in psoriasis patients, independent of traditional cardiovascular risk factors.
  • NCB significantly mediates the relationship between systemic inflammation and LV mass.
  • These findings highlight the potential role of early coronary atherosclerosis in linking systemic inflammation to LV mass.
Abstract

Keywords:
CCTA, cardiac computed tomography angiographyCardiac computed tomography angiographyGlycA, glycoprotein AHDL-C, high-density lipoprotein cholesterolInflammationLDL-C, low- density lipoprotein cholesterolLV, left ventricularLeft ventricular massNCB, noncalcified coronary burdenNoncalcified coronary burdenhs-CRP, high sensitivity-C reactive protein

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