Capillaroscopy. a new application for the evaluation of vascular side-effects induced by chemotherapy

Background: Cancer survivors are rising up, but this better survival is accompanied by possible treatments side-effects. In particular, cardiovascular effects are commonly reported, even if vascular damage is not necessarily connected to clinical manifestations. Periungual microcyrcle evaluation through capillaroscopy could identify asymptomatic patients with high risk of cerebro-cardio- vascular disease. The aim of this pivotal study is to evaluate videocapillaroscopy in patients who undergo chemotherapy, in order to understand if it could represent in future a prognostic tool to predict the risk of cardio-cerebro-vascular events. Methods: We conducted an open-label, uncontrolled study. Patients affected by solid tumors were enrolled. Each subject underwent a clinical evaluation and a videocapillaroscopic examination. Results: We selected 25 patients. Mean age was 55.48 years. Time interval between the start of chemotherapy and capillaroscopy: average 41 months. From our analysis it emerges that ectasia and hemorrhages could be a possible markers of capillary insult caused by chemotherapy. Conclusions: Our study shows the presence of capillaroscopic features that may be peculiar in chemotherapy-induced endothelial damage. The individuation of capillaroscopic alteration specific for chemotherapy-induced endothelial injury could be an important tool to identify patients with high cardiovascular risk.