Objective. Pulmonary arterial hypertension (PAH) is a complication of SSc due to increased vascular resistance, and abnormal vascularity is a well-known feature of the disease as shown by nailfold video-capillaroscopy (NVC). This study investigated for specific NVC changes in SSc patients with and without PAH to assess any useful difference. Methods. Twenty-four SSc patients, 12 with PAH and 12 without, entered the study. Evidence of PAH was defined as increased systolic pulmonary artery pressure (PAP) (epsilon 35 mmHg), indirectly assessed by echocardiography and confirmed by right heart catheterization (mPAP > 25 mmHg). NVC was performed, and a semi-quantitative rating scale, a rating system for avascular areas and a specific NVC pattern evaluation, namely early, active and late, were used. Results. An NVC score > 1 was more frequently found in patients with PAH than those without, 11 cases (92%) vs 5 cases (42%) (P = 0.03); an avascular areas grade > 1 was present in 10 (83%) and 2 (17%) cases, respectively (P = 0.003); and a more severe NC pattern (active/late) was described in 11 (92%) and 5 (42%) patients, respectively (P = 0.03). When we compared the mPAP with NVC parameters, we found significant correlations between mPAP values and the NVC score (P < 0.005) and with the avascular areas score (P < 0.001). Conclusion. Our results underline the relevance of early microvascular assessment in patients at risk of developing a severe complication such as PAH that can amplify the systemic microvascular impairment in SSc. More severe NVC abnormalities should lead to strict cardiopulmonary surveillance and a complete NVC study is indicated.

Systemic sclerosis patients with and without pulmonary arterial hypertension: a nailfold capillaroscopy study / Riccieri, Valeria; M., Vasile; N., Iannace; Stefanantoni, Katia; Sciarra, Iliana; Vizza, Carmine Dario; Badagliacca, Roberto; Poscia, Roberto; Papa, Silvia; Mario, Mezzapesa; Martina, Nocioni; Valesini, Guido. - In: RHEUMATOLOGY. - ISSN 1462-0324. - STAMPA. - 52:8(2013), pp. 1525-1528. [10.1093/rheumatology/ket168]

Systemic sclerosis patients with and without pulmonary arterial hypertension: a nailfold capillaroscopy study

RICCIERI, Valeria;STEFANANTONI, KATIA;SCIARRA, ILIANA;VIZZA, Carmine Dario;BADAGLIACCA, ROBERTO;POSCIA, ROBERTO;PAPA, SILVIA;VALESINI, Guido
2013

Abstract

Objective. Pulmonary arterial hypertension (PAH) is a complication of SSc due to increased vascular resistance, and abnormal vascularity is a well-known feature of the disease as shown by nailfold video-capillaroscopy (NVC). This study investigated for specific NVC changes in SSc patients with and without PAH to assess any useful difference. Methods. Twenty-four SSc patients, 12 with PAH and 12 without, entered the study. Evidence of PAH was defined as increased systolic pulmonary artery pressure (PAP) (epsilon 35 mmHg), indirectly assessed by echocardiography and confirmed by right heart catheterization (mPAP > 25 mmHg). NVC was performed, and a semi-quantitative rating scale, a rating system for avascular areas and a specific NVC pattern evaluation, namely early, active and late, were used. Results. An NVC score > 1 was more frequently found in patients with PAH than those without, 11 cases (92%) vs 5 cases (42%) (P = 0.03); an avascular areas grade > 1 was present in 10 (83%) and 2 (17%) cases, respectively (P = 0.003); and a more severe NC pattern (active/late) was described in 11 (92%) and 5 (42%) patients, respectively (P = 0.03). When we compared the mPAP with NVC parameters, we found significant correlations between mPAP values and the NVC score (P < 0.005) and with the avascular areas score (P < 0.001). Conclusion. Our results underline the relevance of early microvascular assessment in patients at risk of developing a severe complication such as PAH that can amplify the systemic microvascular impairment in SSc. More severe NVC abnormalities should lead to strict cardiopulmonary surveillance and a complete NVC study is indicated.
2013
nailfold videocapillaroscopy; pulmonary arterial hypertension; systemic sclerosis
01 Pubblicazione su rivista::01a Articolo in rivista
Systemic sclerosis patients with and without pulmonary arterial hypertension: a nailfold capillaroscopy study / Riccieri, Valeria; M., Vasile; N., Iannace; Stefanantoni, Katia; Sciarra, Iliana; Vizza, Carmine Dario; Badagliacca, Roberto; Poscia, Roberto; Papa, Silvia; Mario, Mezzapesa; Martina, Nocioni; Valesini, Guido. - In: RHEUMATOLOGY. - ISSN 1462-0324. - STAMPA. - 52:8(2013), pp. 1525-1528. [10.1093/rheumatology/ket168]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/516761
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