Ivone Silva1, Tiago Loureiro2, Andreia Teixeira3, Isabel Almeida4, Armando Mansilha5, Carlos Vasconcelos4, Rui Almeida2. 1. Angiology, Vascular Surgery Service, Clinical Immunology Unit. 2. Angiology and Vascular Surgery Service. 3. Health Information and Decision Sciences Department, Universidade do Porto. 4. Clinical Immunology Unit, Centro Hospitalar do Porto, Praça da Revista o Tripeiro, n° 42, hab 23, 4415-789 Porto, Portugal. 5. Unit of Angiology and Vascular Surgery; Faculty of Medicine of University of Porto.
Abstract
AIM: The aim of this study was to evaluate macrovascular endothelial dysfunction and microvascular damage as clinical markers of peripheral microangiopathy in patients with Raynaud's phenomenon (RP). PATIENTS AND METHODS: Seventy-seven secondary RP with systemic sclerosis, 32 primary RP and 34 healthy controls were included in our study. Secondary RP patients were divided into two subgroups: 39 with digital ulcers (DU) and 38 without digital ulcers (non-DU). RESULTS: Patients with DU had significantly lower flow-mediated dilatation values (5.34 ± 7.49%) compared to non-DU patients (16.21 ± 11.31%), primary RP (17.96 ± 12.78%) and controls (20.17 ± 8.86%), p<0.001, favouring macrovascular endothelium dysfunction. Regarding microvascular damage, the DU group had a predominately capillaroscopic late pattern (71.1%) whereas non-DU patients had an active pattern (56.4%). The microangiopathy evolution score was significantly higher in the DU group compared to the non-DU group (4.79 ± 1.82 vs. 1.79 ± 1.56, p<0.001). Flow-mediated dilation was significantly lower in late pattern (6.13 ± 7.09%) compared to active (12.58 ± 10.66%) and early patterns (17.72 ± 14.90%), p = 0.016 and p = 0.044 respectively. CONCLUSIONS: Low flow-mediated dilatation and microvascular damage in capillaroscopy are early clinical markers of DU risk in RP patients.
AIM: The aim of this study was to evaluate macrovascular endothelial dysfunction and microvascular damage as clinical markers of peripheral microangiopathy in patients with Raynaud's phenomenon (RP). PATIENTS AND METHODS: Seventy-seven secondary RP with systemic sclerosis, 32 primary RP and 34 healthy controls were included in our study. Secondary RP patients were divided into two subgroups: 39 with digital ulcers (DU) and 38 without digital ulcers (non-DU). RESULTS:Patients with DU had significantly lower flow-mediated dilatation values (5.34 ± 7.49%) compared to non-DUpatients (16.21 ± 11.31%), primary RP (17.96 ± 12.78%) and controls (20.17 ± 8.86%), p<0.001, favouring macrovascular endothelium dysfunction. Regarding microvascular damage, the DU group had a predominately capillaroscopic late pattern (71.1%) whereas non-DUpatients had an active pattern (56.4%). The microangiopathy evolution score was significantly higher in the DU group compared to the non-DU group (4.79 ± 1.82 vs. 1.79 ± 1.56, p<0.001). Flow-mediated dilation was significantly lower in late pattern (6.13 ± 7.09%) compared to active (12.58 ± 10.66%) and early patterns (17.72 ± 14.90%), p = 0.016 and p = 0.044 respectively. CONCLUSIONS: Low flow-mediated dilatation and microvascular damage in capillaroscopy are early clinical markers of DU risk in RP patients.
Authors: Alexei A Kamshilin; Igor S Sidorov; Laura Babayan; Maxim A Volynsky; Rashid Giniatullin; Oleg V Mamontov Journal: Biomed Opt Express Date: 2016-11-16 Impact factor: 3.732