Cutolo, M.

Ferrone, C.

Pizzorni, C.

Ravera, F.

Sulli, A.

Zampogna, G.

English

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EWRR abstractsAnn Rheum Dis 2010;69(Suppl 2):A1–A76 A498. Other topicsA124   IMAGING AND RHEUMATIC DISEASES: CORRELATION BETWEEN FINGERTIP BLOOD PERFUSION AND NAILFOLD CAPILLARY IMPAIRMENT IN SYSTEMIC SCLEROSISM Cutolo, C Ferrone, C Pizzorni, F Ravera, G Zampogna, A Sulli Research Laboratory and Academic Unit of Clinical Rheumatology, Department of Internal Medicine, University of Genova, Genova, Italy10.1136/ard.2010.129643aBackground Microvascular involvement is a key feature of systemic sclerosis (SSc). Nailfold capillaroscopy is widely used to evaluate capillary morphology. As well as laser Doppler fl owmetry (LDF), it is a technique for measuring the peripheral microvascular perfusion.1 2 The aim of this study was to inves-tigate possible correlations between fi ngertip blood perfusion (FBP) by LDF and different degrees of microvascular damage by nailfold videocapillaroscopy (NVC) in SSc patients.Methods Forty-six SSc patients (mean±SD age 65±13 years) and 16 healthy subjects (mean age 63±20 years) were enrolled into the study. NVC was performed in order to classify the patients into the proper pattern of nailfold microangiopathy, named ‘early’, ‘active’, or ‘late’ as previously reported.1 LDF (Perimed, Milan) was performed in all the subjects, analysing blood perfusion at 2nd, 3rd, 4th and 5th fi ngertip bilaterally (middle area), both at fi nger basal temperature and after heat-ing the probe at 36°C to evaluate capillary reactivity. The results are expressed as perfusion units (PU). Statistical analy-sis was carried out by non-parametric tests.Results FBP was signifi cantly lower in SSc patients than in healthy subjects (40±41 vs 123±95 PU, p<0.05). The heating of the probe at 36°C induced a signifi cant increase in the FBP in all the subjects (p<0.001), but the variation (delta) was sig-nifi cantly lower in patients with SSc than in healthy controls (23±28 vs 34±53 PU, p<0.05). SSc patients with the ‘late’ NVC pattern of microangiopathy showed lower FBP than patients with the ‘active’ and ‘early’ patterns (31±44, 48±62, 60±96 PU, respectively, at basal temperature; 60±45, 103±38, 169±39 PU, respectively, at 36°C; p<0.05). Furthermore, a negative correlation was observed between FBP and SSc dura-tion. Also, the variation (delta) of the perfusion after heat-ing the probe to 36°C was signifi cantly lower in SSc patients with the ‘late’ pattern of microangiopathy than in those with the ‘active’ and ‘early’ NVC pattern (15±10, 36±21, 99±56 PU, respectively; p<0.05). Limited by the sample size, no signif-icant correlations were found between FBP and pulmonary, oesophageal or renal involvement in SSc patients; however, patients with a history or presence of digital ulcers had lower blood perfusion than those without (28±20, 48±30 PU, respectively, at basal temperature; 56±31, 99±51 PU, respec-tively at 36°C; p<0.05).Conclusions Patients with SSc have a significantly blunted FBP compared with healthy subjects. Capillary reactivity to heating seems partially conserved. The degree of FBP corre-lates with the severity of nailfold microvascular damage.REFERENCES1. Cutolo M, et al. Rheumatology 2004; 43:719–26.2. Murray AK, et al. Arthritis Rheum 2006; 5:1952–60.10.1136/ard.2010.129643c02_ar-69_2(Suppl)-abstract.indd   49 2/17/2010   4:36:05 PM on 30 April 2019 by guest. Protected by copyright.http://ard.bmj.com/Ann Rheum Dis: first published as 10.1136/ard.2010.129643a on 4 April 2011. Downloaded from 

Imaging and rheumatic diseases: correlation between fingertip blood perfusion and nailfold capillary impairment in systemic sclerosis

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Imaging and rheumatic diseases: correlation between fingertip blood perfusion and nailfold capillary impairment in systemic sclerosis

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