Nailfold capillary changes in newly diagnosed hypertensive patients: An observational analytical study

Mishra, Arzoo; Grover, Chander; Singal, Archana; Narang, Shiva; Das, Gopal Krushna

doi:10.1016/j.mvr.2021.104173

“…In patients with hypertension, retinopathy and microalbuminuria, MCD was lower, and dilated capillaries and nonvascular areas were more frequently observed. The authors sug-gested the usefulness of capillaroscopy in the early detection of cardiovascular complications [51].…”

Section: Capillaroscopymentioning

confidence: 99%

Methods for the assessment of microcirculation in patients with hypertension

Lewandowska

¹

,

Marzyńska

²

,

Rzesoś

³

et al. 2023

Arterial Hypertension

0

View full text Add to dashboard Cite

Arterial hypertension (HT) is one of the most common lifestyle diseases worldwide, including Poland. According to World Health Organization, as many as 1.28 billion adults worldwide were suffering from HT in 2011 -a half were unaware of their disease. It is claimed that approximately 10 million of deaths annually are the result of improperly high blood pressure values (BP) [1]. It is estimated that the number of HT patients will exceed 1.5 billion by 2025. Therefore, it classifies HT as a major global healthcare problem [2].According to the WOBASZ II study, more than 40% of the adult Polish population were diagnosed with HT. A constantly increasing trend of newly di-

show abstract

“…Specifically, nail bed capillaroscopy is to evaluate patients with suspicion of systemic sclerosis (mainly), mixed connective tissue disease, and other autoimmune diseases [ 34 ]. It i salso used in non-autoimmune disorders [ 35 – 38 ]. The nailfold capillary evaluation by using videocapillaroscopy (NVC) has been interestingly performed in patients with diabetes mellitus, arterial hypertension, and in subjects with ophthalmologic disorders such as glaucoma and chorioretinitis [ 35 – 37 ].…”

Section: Introductionmentioning

confidence: 99%

“…It i salso used in non-autoimmune disorders [ 35 – 38 ]. The nailfold capillary evaluation by using videocapillaroscopy (NVC) has been interestingly performed in patients with diabetes mellitus, arterial hypertension, and in subjects with ophthalmologic disorders such as glaucoma and chorioretinitis [ 35 – 37 ]. Furthermore, recent findings documented NVC-microangiopathic patterns in AAV patients, with a possible correlation with disease activity [ 38 ].…”

Section: Introductionmentioning

confidence: 99%

Subclinical microvascular changes in ANCA-vasculitides: the role of optical coherence tomography angiography and nailfold capillaroscopy in the detection of disease-related damage

Triggianese

¹

,

D’Antonio

²

,

Nesi

³

et al. 2023

Orphanet J Rare Dis

View full text Add to dashboard Cite

Background Both cardiovascular and complement-mediated disorders might lead to microvascular damages in anti-neutrophil cytoplasm autoantibodies (ANCA)-associated vasculitides (AAV). We aimed at investigating, for the first time, subclinical microvascular abnormalities with non-invasive techniques in AAV patients by analyzing both retinal and nailfold capillary changes. Retinal plexi were investigated using optical coherence tomography angiography (OCT-A), while nailfold capillary changes by video-capillaroscopy (NVC). Potential correlations between microvessels’ abnormalities and disease damage were also explored. Methods An observational study was conducted on consecutive patients who met the inclusion criteria of defined diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA), granulomatosis with polyangiitis (GPA), and microscopic polyangiitis (MPA), age ≥ 18 ≤ 75 yrs, and no ophthalmological disorders. Disease activity was assessed by Birmingham Vasculitis Activity Score (BVAS), damage by Vasculitis Damage Index (VDI), and poorer prognosis by the Five Factor Score (FFS). Quantitative analysis of vessel density (VD) was performed by OCT-A in both superficial and deep capillary plexi. Figures and detailed analysis from NVC were performed for all subjects in the study. Results Included AAV patients (n = 23) were compared with 20 age/sex-matched healthy controls (HC). Retinal VD in superficial whole and parafoveal plexi resulted significantly decreased in AAV compared to HC (P = 0.02 and P = 0.01, respectively). Furthermore, deep whole and parafoveal vessel density was strongly reduced in AAV than HC (P ≤ 0.0001 for both). In AAV patients, significant inverse correlations occurred between VDI and OCTA-VD in both superficial (parafoveal, P = 0.03) and deep plexi (whole, P = 0.003, and parafoveal P = 0.02). Non-specific NVC pattern abnormalities occurred in 82% of AAV patients with a similar prevalence (75%) in HC. In AAV, common abnormalities were edema and tortuosity in a comparable distribution with HC. Correlations between NVC changes and OCT-A abnormalities have not been described. Conclusion Subclinical microvascular retinal changes occur in patients with AAV and correlate with the disease-related damage. In this context, the OCT-A can represent a useful tool in the early detection of vascular damage. AAV patients present microvascular abnormalities at NVC, whose clinical relevance requires further studies.

show abstract

“…In recent years, an increasing focus has emerged on the usefulness of the non-invasive microvascular examination also at the nailfold bed in the context of several systemic diseases, also in non-autoimmune diseases [34][35][36][37][38]. The nailfold capillary evaluation by using videocapillaroscopy (NVC) has been performed in patients with diabetes mellitus, arterial hypertension, and in subjects with ophthalmologic disorders such as glaucoma and chorioretinitis [34][35][36][37]. Interestingly, recent ndings documented NVCmicroangiopathic patterns in AAV patients, with a possible correlation with disease activity [38].…”

Section: Introductionmentioning

confidence: 99%

Subclinical microvascular changes in ANCA-vasculitides: the role of optical coherence tomography angiography and nailfold capillaroscopy in the detection of disease-related damage.

Triggianese

¹

,

D’Antonio

²

,

Nesi

³

et al. 2023

Preprint

0

View full text Add to dashboard Cite

Background Both cardiovascular and complement-mediated disorders might lead to microvascular damages in anti-neutrophil cytoplasm autoantibodies (ANCA)-associated vasculitides (AAV). We aimed at investigating, for the first time, subclinical microvascular abnormalities with non-invasive techniques in AAV patients by analyzing both retinal and nailfold capillary changes. Retinal plexi were investigated using optical coherence tomography angiography (OCT-A), while nailfold capillary changes by video-capillaroscopy (NVC). Potential correlations between microvessels’ abnormalities and disease damage were also explored. Methods An observational study was conducted on consecutive patients who met the inclusion criteria of defined diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA), granulomatosis with polyangiitis (GPA), and microscopic polyangiitis (MPA), age ≥ 18 ≤ 75 yrs, and no ophthalmological disorders. Disease activity was assessed by Birmingham Vasculitis Activity Score (BVAS), damage by Vasculitis Damage Index (VDI), and poorer prognosis by the Five Factor Score (FFS). Quantitative analysis of vessel density (VD) was performed by OCT-A in both superficial and deep capillary plexi. Figures and detailed analysis from NVC were performed for all subjects in the study. Results Included AAV patients (n = 23) were compared with 20 age/sex-matched healthy controls (HC). Retinal VD in superficial whole and parafoveal plexi resulted significantly decreased in AAV compared to HC (P = 0.02 and P = 0.01, respectively). Furthermore, deep whole and parafoveal vessel density was strongly reduced in AAV than HC (P ≤ 0.0001 for both). In AAV patients, significant inverse correlations occurred between VDI and OCTA-VD in both superficial (parafoveal, P = 0.03) and deep plexi (whole, P = 0.003, and parafoveal P = 0.02). Non-specific NVC pattern abnormalities occurred in 82% of AAV patients with a similar prevalence (75%) in HC. In AAV, common abnormalities were edema and tortuosity in a comparable distribution with HC. Correlations between NVC changes and OCT-A abnormalities have not been described. Conclusion Subclinical microvascular retinal changes occur in patients with AAV and correlate with the disease-related damage. In this context, the OCT-A can represent a useful tool in the early detection of vascular damage. AAV patients present microvascular abnormalities at NVC, whose clinical relevance requires further studies.

show abstract

Nailfold capillary changes in newly diagnosed hypertensive patients: An observational analytical study

Cited by 9 publications

References 23 publications

Methods for the assessment of microcirculation in patients with hypertension

Methods for the assessment of microcirculation in patients with hypertension

Subclinical microvascular changes in ANCA-vasculitides: the role of optical coherence tomography angiography and nailfold capillaroscopy in the detection of disease-related damage

Subclinical microvascular changes in ANCA-vasculitides: the role of optical coherence tomography angiography and nailfold capillaroscopy in the detection of disease-related damage.

Contact Info

Product

Resources

About