Nailfold capillary abnormality and pulmonary hypertension in systemic sclerosis

Ohtsuka, Tsutomu; Hasegawa, Akira; Nakano, Akihiko; Yamakage, Akio; Yamaguchi, Mary; Miyachi, Yoshiki

doi:10.1046/j.1365-4362.1997.00088.x

Cited by 35 publications

(27 citation statements)

References 23 publications

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“…The other study, using capillary density and qualitative scoring of nailfold patterns, found no differences in capillary patterns between eight patients with SSc–nonPAH and seven with SSc–PAH, but capillary density in these groups was not reported 15. A third study, using only right heart catheterisation to diagnose and exclude the diagnosis of PAH, showed a significant difference in semi-quantitative scoring of nailfold patterns between SSc–nonPAH and SSc–PAH but, again, capillary density was not assessed in this study 16. Only one of these studies included patients with IPAH and reported no differences in capillary density and capillary patterns between 13 healthy controls and 37 patients with IPAH 15…”

Section: Discussioncontrasting

confidence: 65%

Nailfold capillary density is associated with the presence and severity of pulmonary arterial hypertension in systemic sclerosis

et al. 2008

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Objective: The aim of this study was to investigate whether there are differences in capillary nailfold changes in patients with systemic sclerosis (SSc) with and without pulmonary arterial hypertension (PAH), and whether these changes are associated with PAH severity and disease specificity. Methods: Capillary density and loop dimensions were studied in 21 healthy controls, 20 patients with idiopathic PAH (IPAH) and 40 patients with SSc. Of the 40 patients with SSc, 19 had no PAH (SSc-nonPAH) and 21 had PAH (SSc-PAH), of whom eight had PAH during exercise. Results: Capillary density was lower in SSc-PAH compared with patients who had SSc-nonPAH (4.33/mm vs 6.56/mm respectively, p = 0.001), but loop dimensions were equal. In comparison with IPAH, patients with SSc-PAH had reduced capillary density (4.33/mm vs 7.86/mm, p,0.001) and larger loop dimensions (total width 101.05 mm vs 44.43 mm, p,0.001). Capillary density in healthy controls (9.87/mm) was significantly higher when compared with SSc-nonPAH (6.56/mm), SSc-PAH (4.33/ mm) and with IPAH (7.86/mm). No differences in capillary dimensions were present between healthy controls and IPAH. Capillary density correlated with mean pulmonary arterial pressure (PAP) at rest in SSc-PAH at rest (r = 20.58, p = 0.039) and IPAH (r = 20.67, p = 0.001). Conclusions: Reduction of nailfold capillary density, but not capillary loop dimensions is associated with PAH, and correlates with the severity of PAH in both SSc and IPAH. This suggests that either systemic microvascular changes play a part in the development of PAH, or that PAH itself contributes to systemic microvascular changes.

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Section: Discussioncontrasting

confidence: 65%

Nailfold capillary density is associated with the presence and severity of pulmonary arterial hypertension in systemic sclerosis

et al. 2008

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“…There is clinical and experimental evidence to support the latter concept. As the disease progresses there is an increase in the dropout of nailfold capillaries indicating severe microvascular damage and these changes may correlate with the presence of other vascular consequences, namely PAH [2][3][4]. Studies also clearly demonstrate progressive reduction in the diffusion capacity (DLCO) years prior to the diagnosis of PAH measured by routine screening with Doppler ECHO [5•].…”

Section: Measurement Of Disease Activity In Sscmentioning

confidence: 99%

Microvascular damage in systemic sclerosis: Detection and monitoring with biomarkers

Hummers¹

2006

Curr Rheumatol Rep

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Vascular disease is universal in patients with systemic sclerosis (SSc), but there is a wide variability in its severity. It is clear that there is an early insult to the microvasculature, followed-up by on-going chronic process. This results in profound vascular damage in a subset of patients who develop severe events such as digital loss and pulmonary arterial hypertension. Although there is abundant evidence of vascular perturbation from studies of peripheral blood in SSc, there are few data about the ability to use these biomarkers to predict vascular outcomes. This paper examines the possibility of using circulating biomarkers to assess vascular disease activity and to predict severe vascular events among patients with SSc.

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“…12 Capillary microscopy of the nail fold is recognized as a diagnostic tool in clinical investigation, especially in skin disease, such as psoriasis, and in connective tissue disease, such as systemic sclerosis and scleroderma. [13][14][15] It is a noninvasive method for direct observation of the architecture of the microcirculation. Local vascular abnormalities seem to appear earlier at the nail fold than at other sites on the finger in the course of the disease.…”

Section: Studymentioning

confidence: 99%

Value of Capillary Microscopy in the Diagnosis of Hereditary Hemorrhagic Telangiectasia

Mager¹,

Westermann²

2000

Arch Dermatol

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Nailfold capillary abnormality and pulmonary hypertension in systemic sclerosis

Abstract: Our data suggest that in patients with SSC, nailfold capillary abnormalities correlate with pulmonary arterial hypertension as well as with clinical and laboratory findings indicating pulmonary hypertension.

Cited by 35 publications

References 23 publications

Nailfold capillary density is associated with the presence and severity of pulmonary arterial hypertension in systemic sclerosis

Nailfold capillary density is associated with the presence and severity of pulmonary arterial hypertension in systemic sclerosis

Microvascular damage in systemic sclerosis: Detection and monitoring with biomarkers

Value of Capillary Microscopy in the Diagnosis of Hereditary Hemorrhagic Telangiectasia

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