Standardisation of nailfold capillaroscopy for the assessment of patients with Raynaud's phenomenon and systemic sclerosis

Smith, Vanessa; Herrick, Ariane L.; Ingegnoli, Francesca; Damjanov, Nemanja; Angelis, Rossella De; Denton, Christopher P.; Distler, Oliver; Espejo, Karinna; Foeldvari, Ivan; Frech, Tracy; Garro, Boris; Gutiérrez, Marwin; Gyger, Geneviève; Hachulla, É.; Hesselstrand, Roger; Iagnocco, Annamaria; Kayser, Cristiane; Melsens, Karin; Müller‐Ladner, Ulf; Paolino, Sabrina; Pizzorni, Carmen; Radić, Mislav; Riccieri, Valeria; Snow, M. H.; Stevens, Wendy; Sulli, Alberto; Laar, Jacob M van; Vonk, Madelon C.; Vanhaecke, Amber; Cutolo, Maurizio

doi:10.1016/j.autrev.2020.102458

Cited by 295 publications

(382 citation statements)

References 65 publications

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“…The novelty of our study compared to previous ones is the recruitment of patients across the whole spectrum of precapillary PH. NVC was conducted in all ngers except thumbs and the acquisition of two adjacent images from each nger according to the updated EULAR recommendations [7]. Several studies acquired images only from the fourth nger of the non-dominant hand, which limited the generalizability of their results [15,31].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies acquired images only from the fourth nger of the non-dominant hand, which limited the generalizability of their results [15,31]. In addition, qualitative and semi-quantitative assessment was performed based on a validated algorithm proposed by Smith et al, which facilitates parameters that can be reliably measured by a trained examiner [7,21,32]. The fact that the image analysis was conducted by one examiner could be a limitation, however it was conducted in a blinded manner.…”

Section: Discussionmentioning

confidence: 99%

“…The "overall pattern recognition" was qualitatively assessed based on capillary density, the presence of irregularly enlarged or giant capillaries, hemorrhages and shape abnormalities using a fast track algorithm proposed by Smith et al [7,21]. Images were classi ed as "normal pattern", "nonspeci c pattern" and "scleroderma pattern".…”

Section: Transthoracic Echocardiographymentioning

confidence: 99%

“…Although pulmonary vascular bed has been the main subject of research for many years [4,5], interest has recently started to divert towards the possibility of a co-existing peripheral microangiopathy [6]. Nailfold video-capillaroscopy (NVC) is an established, validated, non-invasive imaging technique for the assessment of peripheral microcirculation, aiding in distinguishing different types of nailfold microvascular abnormalities [7]. It has been originally used in the assessment of Raynaud's phenomenon and the diagnosis of systemic sclerosis (SSc) [8], in which NVC changes may serve as an early prognostic marker that determines the risk of developing PAH [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Peripheral Microangiopathy in Pre-capillary Pulmonary Hypertension: A Nailfold Video Capillaroscopy Prospective Study

Arvanitaki

Giannakoulas

Triantafyllidou

et al. 2020

Preprint

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Background: Although pulmonary vascular bed has been the main subject of research for many years in pulmonary hypertension (PH), interest has recently started to divert towards the possibility of a co-existing peripheral microangiopathy. The aim of this study was to investigate the presence of peripheral microangiopathy in patients with precapillary pulmonary hypertension by exploring nailfold video-capillaroscopic (NVC) structural changes among various subgroups with precapillary PH and to identify possible associations of NVC characteristics with markers of disease severity. Methods: Α cross-sectional study was performed in 46 consecutive patients with precapillary PH [14 with idiopathic pulmonary arterial hypertension (IPAH), 18 with PAH associated with connective tissue diseases (CTD-PAH) and 14 with chronic thromboembolic pulmonary hypertension (CTEPH)] and 30 healthy controls. NVC quantitative and qualitative parameters were evaluated. Results: Patients with precapillary PH (71.7% were women, mean age 60.8 ± 13.4 years) presented reduced capillary density compared to healthy controls (7.5 ± 1.6 loops/mm vs. 9.7 ± 0.81 loops/mm, p<0.001) and increased capillary loop width (18.8 ± 6.7 μm vs. 11.5 ± 2.3 μm, p<0.001) detected mainly in PAH-CTD. Half of patients presented microhaemorrhages on capillary nailfold, while morphological capillary abnormalities where also detected compared to healthy controls. Log10 (NT-proBNP) was independently associated with capillary density in patients with precapillary PH [r= -0.68, B= -1.9, 95% CI (-3,3, -0.4) p=0.014].Conclusion: Significant NVC microvascular changes were detected in patients with various types of precapillary PH, suggesting an impaired peripheral microcirculation associated with right ventricular remodeling parallel to pulmonary vasculopathy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Transthoracic Echocardiographymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Peripheral Microangiopathy in Pre-capillary Pulmonary Hypertension: A Nailfold Video Capillaroscopy Prospective Study

Arvanitaki

Giannakoulas

Triantafyllidou

et al. 2020

Preprint

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“…Die kapillarmikroskopischen Kriterien für die systemische Sklerose sind kürzlich noch einmal überarbeitet worden [16]. Riesenkapillaren kommen auch bei der Dermatomyositis vor und gelegentlich bei der Mixed connective Tissue Disease.…”

Section: Merkeunclassified

Raynaud-Phänomen

Caspary¹

2020

Gefäßmedizin Scan - Zeitschrift für Angiologie, Gefäßchirurgie,

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Das Raynaud-Phänomen ist nach Maurice Raynaud (1834-1881) benannt, der in seiner Promotion 1862 erstmals die "lokale Erstickung" der Extremitäten beschrieben hat [1]. Es bezeichnet eine anfallsweise Verfärbung von peripheren Gliedmaßen aufgrund einer passageren Vasospastik. Die Diagnose lässt sich demnach bereits durch eine präzise Anamnese stellen. Im Zweifelsfall kann man den Patienten Bilder mit den typischen Verfärbungen zeigen und sich ein ähnliches Erscheinungsbild bei ihnen bestätigen lassen; oft legen die Patienten selbst Fotos vor, die während der Anfälle aufgenommen wurden (▶ Abb. 1). Die Prävalenz des Phänomens liegt bei 5 % [2], ist aber in warmen Regionen deutlich geringer, in kalten höher [3]. Die klinische Bedeutung der Erscheinungen ist variabel. Eine sozialmedizinische Relevanz haben sie nur bei einem geringen Teil der Betroffenen. Klinik Bei vollständiger Aufhebung der Perfusion durch den im Bereich der Arteriolen lokalisierten Vasospasmus färben sich die abhängigen Partien weiß ("Leichenfinger"). Erlaubt die Vasospastik eine langsame Restperfusion, wird die Hautfarbe aufgrund der weitgehenden Sauerstoffentsättigung des Hämoglobins livide. Die Verfärbungen können isoliert oder nacheinander auftreten. Nach Ende des Raynaud-Anfalls kommt es teilweise zu einer reaktiven Vasodilatation mit Rötung der Haut durch die resultierende Hyperämie. Merke Die Abfolge "Zyanose (blau) → Vasospastik (weiß) → Hyperämie (rot)" wird als "Trikolorephänomen" bezeichnet und gilt als typisch für das Raynaud-Phänomen, ist aber selten vollständig.

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Systemic Sclerosis

Orteu,

Denton

2024

Rook's Textbook of Dermatology

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Standardisation of nailfold capillaroscopy for the assessment of patients with Raynaud's phenomenon and systemic sclerosis

Cited by 295 publications

References 65 publications

Peripheral Microangiopathy in Pre-capillary Pulmonary Hypertension: A Nailfold Video Capillaroscopy Prospective Study

Peripheral Microangiopathy in Pre-capillary Pulmonary Hypertension: A Nailfold Video Capillaroscopy Prospective Study

Raynaud-Phänomen

Systemic Sclerosis

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