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27.07.2021 | Original Article

Peripheral microcirculatory abnormalities are associated with cardiovascular risk in systemic sclerosis: a nailfold video capillaroscopy study

verfasst von: Eleni Pagkopoulou, Stergios Soulaidopoulos, Eva Triantafyllidou, Alexandra Arvanitaki, Niki Katsiki, Chalarampos Loutradis, Asterios Karagiannis, Michael Doumas, Alexandros Garyfallos, George D. Kitas, Theodoros Dimitroulas

Erschienen in: Clinical Rheumatology | Ausgabe 12/2021

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Abstract

Introduction

Microvascular dysfunction is the key element in the pathogenesis of systemic sclerosis (SSc), whereas the contribution of large and medium size vessel abnormalities is yet to be established. The aim of the present study is to assess the association between micro- and macrovascular function by utilizing a broad spectrum of assessments of vascular performance.

Methods

We included consecutive, consenting SSc patients who underwent nailfold video capillaroscopy (NVC) for microcirculation evaluation. Peripheral and central systolic and diastolic blood pressure, carotid intima-media thickness (cIMT), aortic augmentation index (AIx) corrected for a heart rate of 75 beats per minute (AIx-75), and carotid-femoral pulse wave velocity (PWV) were also performed to assess macrovascular function. Cardiovascular risk disease (CVD) algorithms were also calculated and included in the analysis.

Results

A total of 81 patients (6 males) were studied with mean age 55.44 ± 13.40 years. Reduced capillary density was inversely correlated with arterial stiffness (Alx-75) and augmentation pressure (r = − 0.262, p = 0.018, and r = − 0.249, p = 0.025 respectively). Alx was significantly lower in the early compared to late pattern (28.24 ± 11.75 vs 35.63 ± 10.47, p = 0.036). A significant trend was found among NVC patterns with Alx-75 values being higher with the progression of microangiopathy towards the “late” group (26.36 ± 10.90 vs 30.81 ± 11.59 vs 35.21 ± 7.90, p = 0.027 for trend). Similarly, Framingham risk score and Atherosclerotic Cardiovascular Disease score were progressively higher across the worsening NVC patterns (4.10 ± 4.13 vs 2.99 ± 2.72 vs 6.36 ± 5.65, p = 0.023, and 6.99 ± 7.18 vs 5.63 ± 4.41 vs 12.09 ± 9.90, p = 0.019, respectively, for trends). Finally, QRISK3 (10-year cardiovascular disease risk) and ASCVD (Atherosclerotic Cardiovascular Disease) scores were inversely correlated with the number of capillaries (r = − 0.231, p = 0.048, and r = − 0.260, p = 0.038 respectively).

Conclusion

These data suggest that CVD risk scores and macrovascular parameters are strongly correlated with microvasculopathy in patients with SSc.

Key Points

• Microangiopathy is the hallmark of SSc, but the relationship between subclinical atherosclerosis and small vessel disease remains unknown.

• Arterial stiffening and CVD risk scores are positively associated with the degree of progression of peripheral microvasculopathy assessed with NVC.

• The results of the study suggest an association between NVC abnormalities and higher CVD risk in SSc patients.

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Titel: Peripheral microcirculatory abnormalities are associated with cardiovascular risk in systemic sclerosis: a nailfold video capillaroscopy study
verfasst von: Eleni Pagkopoulou
Stergios Soulaidopoulos
Eva Triantafyllidou
Alexandra Arvanitaki
Niki Katsiki
Chalarampos Loutradis
Asterios Karagiannis
Michael Doumas
Alexandros Garyfallos
George D. Kitas
Theodoros Dimitroulas
Publikationsdatum: 27.07.2021
Verlag: Springer International Publishing
Erschienen in: Clinical Rheumatology / Ausgabe 12/2021
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-021-05795-4

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