Autonomous University of Madrid, Severo Ochoa University Hospital, Rheumatology Department, ciudad universitaria cantoblanco, Avda de Orellana s/n, Madrid, Spain.
Autonomous University of Madrid, La Paz University Hospital, Rheumatology Department, ciudad universitaria cantoblanco, Paseo de la castellana, 261 Madrid, Spain.
Microvasc Res. 2024 Jul;154:104693. doi: 10.1016/j.mvr.2024.104693. Epub 2024 May 1.
Nailfold Videocapillaroscopy (NVC) is a valuable tool in the differential diagnosis of Raynaud's phenomenon (RP), present in certain Rheumatic diseases (RD). Knowing that many people have cardiovascular risk factors (CVRF), the main objective was to demonstrate that CVRF and carotid plaques produce NVC alterations.
Cross-sectional unicentric study carried out from 2020 to 2023. Four groups were formed: subjects with RD and RP, participants with RD without RP, subjects with RP without RD and finally participants without RP or RD (study group). Each subject exhibiting CVRF presented only a single risk factor. The variables collected were: sociodemographic, CVRF (diabetes, tobacco, alcohol (ALC), obesity (OBE), dyslipidemia and arterial hypertension (AH)), diseases, RP, treatments, tortuosities and NVC alterations (ramified capillaries, enlarged capillaries, giant capillaries, haemorrhages and density loss) and carotid ultrasound (CU).
402 subjects were included (76 % women, mean age 51 ± 16 years), 67 % had CVRF, 50 % RP and 38 % RD. Tortuosities were present in 100 % of CVRF participants. A statistically significant association was found between the presence of CVRF and all the NVC alterations: ramified capillaries (OR = 95.6), enlarged capillaries (OR = 59.2), giant capillaries (OR = 8.32), haemorrhages (OR = 17.6) and density loss (OR = 14.4). In particular, an association was found between giant capillaries with AH (p = 0,008) and OBE (p 〈0,001), and haemorrhages and density loss with ALC and OBE (p < 0,001). On the other hand, 40 subjects presented CU plaques (9.9 %), associated with enlarged capillaries (OR = 8.08), haemorrhages (OR = 4.04) and ramified capillaries (OR = 3.01). The pathological intima-media thickness was also associated with haemorrhages (OR = 3.14).
There is a clear association between CVRF and ultrasound atherosclerotic findings in carotid with NVC alterations. These findings are of special interest for a correct NVC interpretation and to avoid false positives in the diagnosis of primary and secondary RP.
甲襞毛细血管显微镜检查（NVC）是鉴别雷诺现象（RP）的一种有价值的工具，在某些风湿性疾病（RD）中存在。由于许多人存在心血管危险因素（CVRF），主要目的是证明 CVRF 和颈动脉斑块会导致 NVC 改变。
这是一项 2020 年至 2023 年进行的横断面单中心研究。共分为 4 组：有 RD 和 RP 的受试者、有 RD 无 RP 的参与者、有 RP 无 RD 的受试者以及无 RP 或 RD 的参与者（研究组）。每位存在 CVRF 的受试者仅表现出单一风险因素。收集的变量包括：社会人口统计学、CVRF（糖尿病、烟草、酒精（ALC）、肥胖（OBE）、血脂异常和动脉高血压（AH））、疾病、RP、治疗、扭曲和 NVC 改变（分支毛细血管、扩张毛细血管、巨毛细血管、出血和密度损失）以及颈动脉超声（CU）。
共纳入 402 名受试者（76%为女性，平均年龄 51±16 岁），67%存在 CVRF，50%有 RP，38%有 RD。存在 CVRF 的受试者 100%存在扭曲。存在 CVRF 与所有 NVC 改变均存在统计学显著相关性：分支毛细血管（OR=95.6）、扩张毛细血管（OR=59.2）、巨毛细血管（OR=8.32）、出血（OR=17.6）和密度损失（OR=14.4）。特别是，巨毛细血管与 AH（p=0.008）和 OBE（p〈0.001），以及出血和密度损失与 ALC 和 OBE（p〈0.001）之间存在相关性。另一方面，40 名受试者存在颈动脉 CU 斑块（9.9%），与扩张毛细血管（OR=8.08）、出血（OR=4.04）和分支毛细血管（OR=3.01）相关。病理内中膜厚度也与出血（OR=3.14）相关。
CVRF 与颈动脉超声粥样硬化发现与 NVC 改变之间存在明显相关性。这些发现对于正确解释 NVC 和避免原发性和继发性 RP 诊断中的假阳性具有特殊意义。
