Abstract Details

Title Quantitative MRI in Multiple Sclerosis Patients with Hypertension

Topic Multiple Sclerosis

Presentation(s) P1 - Poster Session 1 (12:00 PM-1:00 PM)

Poster/Presentation
Number 9-019

Objective To examine the impact of hypertension on quantitative magnetic resonance imaging (MRI) measures in multiple sclerosis (MS).

Background Cardiovascular comorbidities, including hypertension, are common in MS and are associated with worse outcomes.

Design/Methods We conducted a cross-sectional analysis of all patients who underwent quantitative MRI at our center from June 2015 - August 2019. Brain MRIs were quantitatively analyzed via a fully-automated method to calculate T2 lesion volume (T2LV), brain parenchymal fraction (BPF), and spinal cord area (SCA). Our electronic medical record (Epic) was queried to determine the number of hypertension diagnosis codes entered for each patient. Those with ≥2 entries were considered to have hypertension. Univariable and multivariable linear regression models were used to determine the relationship between hypertension and quantitative MRI metrics.

Results We identified 918 patients who underwent quantitative MRI, of whom 126 had hypertension. The average age among hypertensives was 52.2 years with average disease duration of 17.2 years. Those without hypertension had an average age and disease duration of 45.1 years and 13.3 years respectively. On univariable analysis, patients with hypertension had BPF that was 1.4% lower (p<0.0001), T2LV that was 7.5 mL greater (p<0.0001), and SCA that was 1.8 mm² less (p=0.05) than those without hypertension. After adjusting for age, hypertension was still significantly associated with T2LV (p=0.0005), but not BPF (p=0.15) or SCA (p=0.4). When adjusting for age, disease duration, MS phenotype, sex, and race, there were no significant associations with hypertension.

Conclusions Hypertension was associated with greater T2LV, even after controlling for age, suggesting this comorbidity is an important mediator of disease activity. When adjusting for additional clinical factors, hypertension was not associated with our MRI measures suggesting its effects may be mediated through one of our covariates. Additional analysis is needed to determine if chronic small vessel disease contributes to higher T2LV in hypertensive patients.

Authors/Disclosures
Justin Abbatemarco, MD PRESENTER	Dr. Abbatemarco has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Abbatemarco has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Abbatemarco has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech . Dr. Abbatemarco has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics, Inc.. Dr. Abbatemarco has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. The institution of Dr. Abbatemarco has received research support from Amgen.
Kunio Nakamura, PhD (Cleveland Clinic)	Dr. Nakamura has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for INmune Bio. The institution of Dr. Nakamura has received research support from Biogen. The institution of Dr. Nakamura has received research support from PCORI. The institution of Dr. Nakamura has received research support from NIH. The institution of Dr. Nakamura has received research support from Genzyme. The institution of Dr. Nakamura has received research support from NIH. The institution of Dr. Nakamura has received research support from Genzyme. The institution of Dr. Nakamura has received research support from Novartis. The institution of Dr. Nakamura has received research support from DOD. Dr. Nakamura has received intellectual property interests from a discovery or technology relating to health care.
Scott Husak	Scott Husak has nothing to disclose.
Daniel Ontaneda, MD, PhD, FAAN (Cleveland Clinic)	Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech/Roche. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen Idec. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. The institution of Dr. Ontaneda has received research support from NIH. The institution of Dr. Ontaneda has received research support from PCORI. The institution of Dr. Ontaneda has received research support from NMSS. The institution of Dr. Ontaneda has received research support from Genetech.
Robert A. Bermel, MD, FAAN (Cleveland Clinic)	Dr. Bermel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi/Genzyme. Dr. Bermel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech/Roche. Dr. Bermel has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Bermel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for TG Therapeutics. The institution of Dr. Bermel has received research support from Biogen. The institution of Dr. Bermel has received research support from Roche. The institution of Dr. Bermel has received research support from Novartis. Dr. Bermel has received intellectual property interests from a discovery or technology relating to health care.
Devon Conway, MD	Dr. Conway has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Conway has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Conway has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Conway has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amgen. Dr. Conway has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Conway has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Conway has received research support from Novartis. The institution of Dr. Conway has received research support from BMS. The institution of Dr. Conway has received research support from Biogen.