By using a videomicroscopy system, images of toe nail fold capillaries from 33 male smokers with atherosclerosis, 19 healthy male smoker controls, and 19 healthy male nonsmoker controls were recorded on video tape. Control subjects did not have clinical evidence of atherosclerosis. Capillary diameters were measured from the video tape with an image shearing device. The mean diameters ( t SD) for the atherosclerotic patients, nonsmoker controls, and smoker controls were 13.7 p m (k4.7 pm), 11.1 pm (?3.4 pm), and 9.6 p m ( t 3.4 pm), respectively. Statistical difference between the atherosclerotic patients and nonsmoker controls was significant at P < 0.02; the difference between the atherosclerotic patients and smoker controls was significant at P < 0.001. Statistical difference between the two control groups was not significant.These data indicate that atherosclerotic lesions elicit chronic dilation of distal cutaneous capillaries in patients who are smokers. However, comparison of these patients with tobacco smokers who are asymptomatic for atherosclerosis suggest that capillary dilation in atherosclerosis is attributable to the disease process itself and not to the effects ofcigarette smoking. This dilation of cutaneous capillaries in the atherosclerotic toe nail fold may be caused by angiogenic factors released secondary to chronic ischemia.
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