Rheumatology · Mar 19, 2026
Comparable Carotid Vascular Biomechanics in Ankylosing Spondylitis and Psoriatic Arthritis: A Head-to-Head Echo-Tracking Ultrasound Study
By Markov M, Georgiev T, Dimova M et al.
Background: Spondyloarthritis, including ankylosing spondylitis (AS) and psoriatic arthritis (PsA), is associated with increased cardiovascular risk that may not be fully captured by conventional risk assessment tools. Arterial stiffness and carotid intima–media thickness (CIMT) represent early markers of vascular ageing; however, direct comparisons of local carotid biomechanical properties between AS and PsA remain limited. Objectives: To compare structural and functional carotid vascular parameters derived from one-point echo-tracking ultrasound between patients with AS and PsA and to explore clinical, metabolic and haemodynamic correlates of arterial stiffness. Methods: In this cross-sectional study, 108 patients with spondyloarthritis (71 AS, 37 PsA) underwent vascular ultrasound assessment including CIMT, local pulse wave velocity (PWVβ), β-stiffness index, Peterson’s elastic modulus (Ep), arterial compliance (AC) and augmentation index (AI). Clinical characteristics, inflammatory markers, lipid profile and cardiovascular risk scores were recorded. Between-group comparisons were performed using non-parametric tests. Spearman correlations and multivariable linear regression analyses were applied to identify factors associated with vascular parameters. Results: Baseline demographic and metabolic characteristics were comparable between groups, although sex distribution differed (p = 0.002). Most structural and functional vascular indices, including CIMT, PWVβ, β-stiffness index, AC and Ep, did not differ significantly between AS and PsA. Augmentation index was higher in PsA compared with AS (median 21.9 vs 12.8, p = 0.029). CIMT correlated positively with β-stiffness index (ρ = 0.404), PWVβ (ρ = 0.482) and Ep (ρ = 0.451) (all p < 0.001). In multivariable regression models, arterial hypertension emerged as the most consistent independent factor associated with vascular parameters, while inflammatory markers showed limited associations. Conclusion: Patients with ankylosing spondylitis and psoriatic arthritis demonstrate broadly comparable local carotid vascular profiles when assessed using echo-tracking ultrasound. Higher augmentation index in psoriatic arthritis suggests differences in haemodynamic wave reflection rather than intrinsic arterial stiffness. Vascular alterations appear to be driven predominantly by haemodynamic and metabolic factors rather than disease phenotype alone.