Document Detail

Nailfold capillary density is associated with the presence and severity of pulmonary arterial hypertension in systemic sclerosis.
MedLine Citation:
PMID:  18375538     Owner:  NLM     Status:  MEDLINE    
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 microm vs 44.43 microm, 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 = -0.58, p = 0.039) and IPAH (r = -0.67, 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.
H M A Hofstee; A Vonk Noordegraaf; A E Voskuyl; B A C Dijkmans; P E Postmus; Y M Smulders; E H Serné
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Publication Detail:
Type:  Journal Article     Date:  2008-03-28
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  68     ISSN:  1468-2060     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-13     Completed Date:  2009-02-25     Revised Date:  2009-09-22    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  191-5     Citation Subset:  IM    
Department of Internal Medicine, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
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MeSH Terms
Capillaries / pathology
Cardiac Output
Exercise Test / methods
Hypertension, Pulmonary / etiology*,  pathology,  physiopathology
Microscopic Angioscopy / methods
Middle Aged
Nails / blood supply*
Scleroderma, Systemic / complications*,  pathology,  physiopathology
Severity of Illness Index
Vascular Resistance

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