Abstract

Systemic sclerosis is an autoimmune disease characterized by organ fibrosis and vasculopathy. Almost all patients suffer from Raynaud’s phenomenon. Nailfold video capillaroscopy is the most widely imaging technique available, but flow quantification is impossible. Therefore, novel imaging techniques are of interest. We performed a single-center feasibility study using Microvascular Imaging (MVI) for flow quantification of small fingertip vessels. We compared 20 healthy controls (HCs) with 20 systemic sclerosis (SSc) patients. In HCs, measurements were, on average, statistically significantly higher when combined for all fingers (median 10.68 vs. 6 cm/s, Δ = 4.68 cm/s, p < 0.0001) and for individual fingers. An optimal cut-off value of peak systolic (PS) velocity of <6.13 cm/s and end-diastolic (ED) velocity of <2.13 cm/s discriminated HCs from SSc. Test characteristics for PS showed excellent sensitivity (0.90, 95% CI 0.70–0.98) and specificity (0.85, 95% CI 0.64–0.95; LR + 6.0). For ED velocity, sensitivity was 0.85 (95% CI 0.64–0.95) and specificity was 0.80 (95% CI 0.58–0.92, LR + 4.25). Here, we present the first study on the use of MVI to assess blood flow in the fingertips with high sensitivity and specificity in SSc. Future studies are needed to investigate correlations with the risk of organ complications, such as digital ulcers or pulmonary arterial hypertension.

Highlights

  • Systemic sclerosis (SSc) is a systemic autoimmune disorder characterized by skin and organ fibrosis and vasculopathy [1]

  • healthy controls (HCs) were significantly younger than the SSc patients, age did not have a relevant influence on the digital flow velocities based on our results

  • We present the first study on the use of Microvascular Imaging (MVI) as a novel imaging technique to measure blood flow velocity in patients with SSc

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Summary

Introduction

Systemic sclerosis (SSc) is a systemic autoimmune disorder characterized by skin and organ fibrosis and vasculopathy [1]. The latter affects about 90–100% of patients; clinically, this is evident by the presence of Raynaud’s phenomenon (RP) and potential complications, including digital ulcers (DU) [2]. Several non-invasive methods, including NVC, thermal imaging, and various Doppler ultrasound (US)-based techniques, have been described to assess the microvasculature [6]. These are cumbersome to perform, have relatively high costs, or require specialized equipment not readily available at most centers. Novel methods and applications that are widely available and easy to perform are required to assess functional blood flow changes in affected fingers

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