Fourth Department of Internal Medicine, Hippokration General Hospital, Medical School, Aristotle University of Thessaloniki, Konstantinoupoleos Str. 49, Thessaloniki, Greece.
Second Propedeutic Department of Internal Medicine, Hippokration General Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Arthritis Res Ther. 2019 Nov 27;21(1):253. doi: 10.1186/s13075-019-2051-3.
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. The aim of the present study is to investigate the association between micro- and macrovascular involvement in the setting of SSc.
Consecutive, consenting SSc patients were assessed by nailfold video-capillaroscopy (NVC) to evaluate the microcirculation. The number of capillaries per mm 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.
A total of 37 patients were studied. A significant correlation was observed between AIx and the average number of capillaries per mm (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.
These data suggest that arterial stiffness (as assessed by AIx-75) correlates with microvascular damage in patients with SSc.
虽然系统性硬化症（SSc）中的微血管病变已有充分记录，但 SSc 与大血管疾病之间的潜在联系仍存在争议，有待确定。本研究旨在探讨 SSc 中微血管和大血管受累之间的关联。
对连续同意的 SSc 患者进行甲襞视频毛细血管镜（NVC）评估以评估微循环。测量每毫米毛细血管数和毛细血管溃疡风险指数（CSURI），并将发现也分为三种硬皮病模式（即早期、活跃期和晚期）。还测定颈动脉内膜-中层厚度（IMT）、校正心率为 75 次/分钟的主动脉增强指数（AIx-75）、颈动脉-股动脉脉搏波速度（PWV）以及中心收缩压和舒张压，以评估大血管功能。
共研究了 37 例患者。AIx 与平均每毫米毛细血管数之间存在显著相关性（r = -0.34，p = 0.047），AIx 与 CSURI 之间也存在显著相关性（r = 0.35，p = 0.044）。“早期”硬皮病模式患者的 AIx 值低于“活跃期”（20.5 ± 11.4 与 34.1 ± 11.5%，p = 0.02）和“晚期”（20.5 ± 11.4 与 33.4 ± 8.8%，p = 0.05）模式。在大血管生物标志物（PWV、颈动脉 IMT、中心收缩压和舒张压）与毛细血管镜测量之间未发现其他显著相关性。
这些数据表明，动脉僵硬度（通过 AIx-75 评估）与 SSc 患者的微血管损伤相关。
