Bieber Amir, Dolnikov Katya, Chizik Victoria, Novofastovsky Irina, Fawaz Abdallah, Balbir-Gurman Alexandra, Mader Reuven
Rheumatic Diseases Unit, Ha'Emek Medical Center, 18101, Afula, Israel.
The B. Shine Rheumatology Institute, Rambam Health Care Campus, Haifa, Israel.
Clin Rheumatol. 2020 Sep;39(9):2671-2676. doi: 10.1007/s10067-020-05025-3. Epub 2020 Mar 10.
The aim of the study was to evaluate the interrelationship between the micro- and macrovasculature.
This is a cross-sectional study that examined SSc patients and fibromyalgia (FM) patients as controls. We assessed forearm peripheral vascular status and nailfold capillaroscopy. We evaluated the association between nailfold capillaroscopy pattern of microvasculopathy reflected as microangiopathy evolution score and macrovascular changes in the forearm vessels examined by color Doppler ultrasound. We assessed relevant clinical and laboratory data, as well as intima-media thickness (IMT) and internal diameter (ID) in the radial and ulnar arteries in millimeters, and calculated the ratio IMT\ID peak systolic velocity and end-diastolic velocity were used for the calculation of the resistance index.
We examined 73 patients: 50 patients with SSc and 23 patients with FM. Ten patients with SSc had arterial occlusions compared to 1 among FM patients (p = 0.082). The SSc group had a statistically significantly higher mean IMT to ID ratio (p < 0.001). There was no correlation between microangiopathy evolution score for both hands, RI, or mean IMT/ID ratio. Total microangiopathy evolution score was not associated with arterial occlusions.
Our study demonstrated a high prevalence of macrovascular disease in SSc; no correlation was found between microvasculopathy and macrovascular disease, suggesting that different pathogenic mechanisms might operate in different vessels size. Key Points • This study demonstrated a high prevalence of macrovascular arterial forearm disease in systemic sclerosis patients. • This study found no correlation between capillaroscopic microangiopathy evolution score (MES) and macrovascular abnormalities. • Our findings suggest that different pathogenic mechanisms might operate in different vessels size.
本研究旨在评估微血管与大血管之间的相互关系。
这是一项横断面研究，以硬皮病患者为研究对象，纤维肌痛（FM）患者作为对照。我们评估了前臂外周血管状况和甲襞毛细血管镜检查。我们评估了以微血管病变演变评分反映的微血管病甲襞毛细血管镜检查模式与通过彩色多普勒超声检查的前臂血管大血管变化之间的关联。我们评估了相关的临床和实验室数据，以及桡动脉和尺动脉的内膜中层厚度（IMT）和内径（ID）（单位为毫米），并计算了IMT\ID比值。收缩期峰值流速和舒张末期流速用于计算阻力指数。
我们检查了73例患者：50例硬皮病患者和23例FM患者。10例硬皮病患者存在动脉闭塞，而FM患者中只有1例（p = 0.082）。硬皮病组的平均IMT与ID比值在统计学上显著更高（p < 0.001）。双手的微血管病演变评分、阻力指数或平均IMT/ID比值之间均无相关性。微血管病总演变评分与动脉闭塞无关。
我们的研究表明硬皮病中大血管疾病的患病率很高；未发现微血管病与大血管疾病之间存在相关性，这表明不同的致病机制可能在不同大小的血管中起作用。要点 • 本研究表明系统性硬化症患者前臂大血管动脉疾病的患病率很高。 • 本研究发现毛细血管镜微血管病演变评分（MES）与大血管异常之间无相关性。 • 我们的研究结果表明不同的致病机制可能在不同大小的血管中起作用。
