Abstract
BackgroundWhile microangiopathy is well-documented in systemic sclerosis (SSc), a potential link between SSc and macrovascular disease is highly debated and remains to be established. The aim of the present study is to investigate the association between micro- and macrovascular involvement in the setting of SSc.MethodsConsecutive, consenting SSc patients were assessed by nailfold video-capillaroscopy (NVC) to evaluate the microcirculation. The number of capillaries per mm2 and the capillaroscopic skin ulcer risk index (CSURI) were measured, and findings were also classified into three scleroderma patterns (i.e., early, active, and late). Carotid intima-media thickness (IMT), aortic augmentation index corrected for a heart rate of 75 beats per minute (AIx-75), carotid-femoral pulse wave velocity (PWV), and central systolic and diastolic blood pressure were also determined to assess macrovascular function.ResultsA total of 37 patients were studied. A significant correlation was observed between AIx and the average number of capillaries per mm2 (r = − 0.34, p = 0.047) and between AIx and CSURI (r = 0.35, p = 0.044). Patients with the “early” scleroderma pattern had lower AIx values compared with “active” (20.5 ± 11.4 vs 34.1 ± 11.5%, p = 0.02) and “late” (20.5 ± 11.4 vs 33.4 ± 8.8%, p = 0.05) patterns. No other significant correlations were found between macrovascular biomarkers (PWV, carotid IMT, systolic and diastolic central blood pressure) and the capillaroscopic measurements.ConclusionsThese data suggest that arterial stiffness (as assessed by AIx-75) correlates with microvascular damage in patients with SSc.
Highlights
Systemic sclerosis (SSc) is a heterogeneous connective tissue disorder characterized by extensive fibrosis of the skin and progressive multi-organ involvement [1]
The relationship between macrovascular atherosclerotic markers namely carotid intimamedia thickness, pulse wave velocity (PWV) and nailfold video-capillaroscopy (NVC) patterns has not been adequately studied in systemic sclerosis (SSc) individuals
Few studies have addressed this question, providing limited data regarding the association between carotid intimamedia thickness (cIMT) [10], brachial artery flow-mediated dilatation (FMD) [11], arterial stiffness [12], and NVC abnormalities
Summary
Systemic sclerosis (SSc) is a heterogeneous connective tissue disorder characterized by extensive fibrosis of the skin and progressive multi-organ involvement [1]. Few studies have addressed this question, providing limited data regarding the association between cIMT [10], brachial artery flow-mediated dilatation (FMD) [11], arterial stiffness [12], and NVC abnormalities. These studies suggest a link between micro- and macrovascular alterations in SSc. While microangiopathy is well-documented in systemic sclerosis (SSc), a potential link between SSc and macrovascular disease is highly debated and remains to be established.
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