Systemic sclerosis & Raynaud's
Significant nailfold capillary loss and late capillaroscopic pattern are associated with pulmonary arterial hypertension in systemic sclerosis
Authors' conclusion
Our results indicate that the distinctive peripheral microcirculatory injury of SSc, i.e. capillary loss and morphological abnormalities, appear more severe and pronounced in patients with SSc-PAH.
Study context
- Population
- SSc patients with and without a diagnosis of pulmonary arterial hypertension (PAH)
- Participants
- 110 patients
- Exposure
- SSc with PAH vs SSc without PAH
- SSc-PAHn = 55
- SSc-nonPAHn = 55reference
- Outcome
- Differences in NVC findings (patterns and morphological parameters)
Methodological detailscase-control, multicentre, semiquantitative scoring system, multivariate analysis
- Case-control
- Multicentre
- Semiquantitative scoring system
- Multivariate analysis
Main finding
As reported in the abstract
NVC findings, multivariate analysis
SSc-PAH vs SSc-nonPAHAdjusted odds ratio (95% CI)
Non-specific abnormalities: 27/55, 49.1%vs 10/55, 18.2%
16.89(3.06–93.16)
Lower capillary density (grade 3): 20/55, 36.4%vs 5/55, 9.1%
38.33(2.34–367.80)
Avascular areas: 18/55, 32.7%vs 10/55, 18.2%
16.90(2.64–44.35)
- Late pattern more frequent in SSc-PAH
- P < 0.01
- Non-specific abnormalities more frequent in SSc-PAH
- P < 0.01
- Lower capillary density in SSc-PAH
- P < 0.01
- Higher avascular areas in SSc-PAH
- P < 0.01
- Higher mean nailfold videocapillaroscopy (NVC) score in SSc-PAH
- P < 0.01
- Early/active pattern more frequent in non-PAH
- P < 0.01
- Higher rate of micro-haemorrhages in non-PAH
- P = 0.04
Observational data: associations, not effects.
Further findings
Correlation of mean pulmonary arterial pressure with NVC parameters
- Correlation with avascular areas
- P < 0.01
- Correlation with capillary density
- P < 0.01
- Correlation with non-specific abnormalities
- P < 0.01
Original publication
Significant nailfold capillary loss and late capillaroscopic pattern are associated with pulmonary arterial hypertension in systemic sclerosis. Rheumatology (Oxford). Published 25 August 2023. doi:10.
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