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BackgroundDifferent studies and meta-analysis have shown that subclinical atherosclerosis (AS) and vascular complications (VC) are higher in patients with Systemic Sclerosis (SSc) than in healthy population. However, the relationship between macrovascular damage and microvascular affection has not been adequately studied by specific techniques such as capillaroscopy.ObjectivesTo explore the possible relation between several macrovascular disease variables (carotid doppler ultrasound, ankle-brachial index [ABI]) and capillaroscopy findings in patients with SSc.MethodsTransverse descriptive study with analytical components. Study population: a cohort of 115 patients with SSc controlled in the Rheumatology Department of a tertiary hospital. Variables: 1) clinical variables; 2) capillaroscopy study: findings of scleroderma pattern (megacapillaries, haemorrhages and avascular areas) and classification of evolving patterns according to Cutolo et. Al.; 3) vascular study: ankle-brachial index (ABI) and carotid doppler ultrasound (ESAOTE MyLab XV70, 7–12 MHz linear transducer, software RFQIMT) measuring intima-media thickness (IMT) and presence of atheroma plaques (Mannheim Consensus). A vascular surgeon measured ABI and the capillaroscopy and carotid doppler ultrasound were done by a highly experienced rheumatologist, blind to the rest of findings, in a term of 3 months after the initial evaluation. Statistical analysis: IBM-SPSS Statistics v22.0 package.Results115 patients where included consecutively, of which 108 were studied; with a mean age of 60,16 years (SD ±15.16); 99 women (91.7%) and 9 men (8.3%). Mean SSc evolution was 11.45 years (SD ±8.84). LSSc was most frequently diagnosed (50%), followed by SSc without scleroderma (18.5%) and, decreasingly, DSSc (16.7%), overlap syndrome (9.3%) and pre-SSc (5.6%). The mean right side IMT was 0,579 mm (SD ± 0,126), and the left side 0,657 mm (SD ± 0,158); 33,3% had atheroma plaques. In total, 37% had a pathological carotid ultrasound, and 39,8% had macrovascular damage (atheroma plaque and/or IMT >0,9 mm and/or ABI<0,9). In the capillaroscopy study, megacapillaries, haemorrhages and avascular areas were found in a 82,4%, 74,1% and 56,5% of patients, respectively. When re-classifying the findings according to Cutolo et al, 31,5% of patients showed an early pattern, 37% an active pattern and a 22,2% a late SSc pattern.In the bivariate analysis, the existence of macrovascular affection showed an association with a capillary pattern with more avascular areas and fewer megacapillaries. Statistically, this association was significant between the presence of avascular areas and the macrovascular damage (χ2=4,412; p-value = 0,036) and the pathological carotid ultrasound (χ2=4,107; p-value = 0,043) variables. A tendency towards an association between these last two macrovascular variables and capillaroscopy patterns of major microvascular damage was seen.ConclusionsNailfold capillaroscopy might be a useful tool to predict the presence of AS and macro vascular damage in patients with...

BackgroundRheumatoid arthritis (RA) is associated with increased morbidity and mortality related to cardiovascular disease (CVD). Physical exercise (PE) is related with significant beneficial effects on the CV system; however, in patients with RA few studies demonstrate that PE is beneficial for functional prognosis or surrogate markers of CVD in RA.ObjectivesTo determine the effect of PE and hours of weekly physical activity on subclinical CVD markers in patients with RA.MethodsThe study was developed over a period of two years. Patients were asked, by clinical interview, for regular PE practice (minimum three times per week, at least 30'), and the time spent walking daily in their normal duties was recorded. Demographic and clinical variables (age, gender, body mass index (BMI), duration of RA, smoking, hypertension (HT), dislypidemia (DL), atherogenic index (AI)) were determined. History of cardiovascular events (ischemic heart disease or stroke), diabetes mellitus (DM), or severe chronic renal disease (defined by a glomerular filtration rate <60) were considered exclusion criteria. Vascular damage was estimated by measuring systolic blood pressure (SBP) and pulse wave velocity (PWV), and a second determination was performed in a period of a year in 65 patients. PWV determination was performed by a validated device called MobilOGraph®. Patients were classified as having high CVR if the PWV> =10m/s. Intima media thickness (IMT) and the presence of atheromatous plaques were determined by ultrasound in the extracranial carotideal tree in accordance with Mannheim's consensus. Ultrasound examination was performed with an ultrasound Esaote MyLab xv70 with linear probe (7-12mHz) and an automated program that IMT measured by radio frequency (“Quality intima media Thickness in Real-time, QIMT”). The SPSS 17.0 program for descriptive statistics was used to analyze the data.ResultsWe evaluated 181 consecutive patients with RA without history of high CV risk. 77.9% of patients were female, with mean age of 58.77±13,06 years, mean BMI of 27.13±4,73; 18.4% were obese (IMC≥30). Other parameters were: average duration of 13,62±10,51 years-disease, 29.8% smokers, 30.9% HT, 42.5% DL, and average AI was 3,84±1,01. Additionally, average cIMT was 722±149,29mm, 12.7% had pathological cIMT (>0.9mm), 42% had plaques, and 26.1% had pathological PWV (average of 8,53±2,14m/s). There were observed differences in markers of vascular damage (PWV, cIMT, central and peripheral SBP) and clinical variables (age, BMI, AI) related with PE, although it did not reach statistical significance. PWV monitoring was performed in 65 patients for whom no association with PE practice and daily exercise was observed.ConclusionsThe PE did not demonstrate effect on surrogate markers of cardiovascular risk or clinical aspects in our RA population.Disclosure of InterestNone declared