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AB0601 Anatomic and functional assessment of peripheral perfusion in patients with systemic sclerosis. is there any correlation between capillaroscopic findings and ergospirometry?

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Background Microvasculopathy of systemic circulation in patients with Systemic Sclerosis (SS) is widely assessed by digital capillaroscopy (DC), a method that evaluates the architecture of capillary network and reveals changes… Click to show full abstract

Background Microvasculopathy of systemic circulation in patients with Systemic Sclerosis (SS) is widely assessed by digital capillaroscopy (DC), a method that evaluates the architecture of capillary network and reveals changes of vascular anatomy. On the other hand, ergospirometry (ERG) reveals functional impairment of microcirculation by assessing indirect measures of peripheral tissue ischemia (most suitable VE/VCO2). Since today, there have been studies correlating DC findings with spirometric parameters (respiratory volumes)1,2; nevertheless, no reports have been published correlating the same DC findings with ERG parameters (functional microvascular perfusion). Objectives To propose the use of DC as a screening tool for impaired functional microvasculopathy by investigating correlations between patterns of capillaroscopic findings with ergospirometric values of peripheral tissue blood perfusion. Methods 11 patients (11 women mean age 43+/- 12 ys) with SS were evaluated contemporary with High Resolution Computed Tomography of the chest, ERG, and DC. Parameters were correlated with multiple regression analysis. Statistic significance was considered p<0.05. Results Patient data are shown in the table. Diffuse scleroderma 6/11 Limited scleroderma 5/11 Pulmonary hypertension 4/11 History of digital ulcers 5/11 Time of endurance in minutes (ergospirometry) 5':32” (±65”) Diffusion capacity (%pred) 82±15 Pulmonary fibrosis 7/11 VE/VCO2 (mean values ± sd) 32±5 Patterns of capillaroscopy 1/11 normal 1/11 early 4/11 active 5/11 late Patients with late pattern in capillaroscopy had less endurance in exercise test (P<0.05) but no correlation was found between capillaroscopic pattern and VE/VCO2 (P>0.05). Age was a crucial confounding factor. Conclusions The correlation of late pattern capillaroscopy findings with reduced ergospirometric endurance in 11 patients indicates that in a larger cohort, specific parameter associations between DC and ERG are probable to emerge. References Ghizzoni C, Sebastiani M, Manfredi A, et al. Prevalence and evolution of scleroderma pattern at nailfold videocapillaroscopy in systemic sclerosis patients: Clinical and prognostic implications. Microvasc Res. 2015 May; 99: 92–5. Castellví I, Simeόn-Aznar CP, Sarmiento M, et al. Association Between Nailfold Capillaroscopy Findings and Pulmonary Function Tests in Patients with Systemic Sclerosis. J Rheumatol. 2015 Feb; 42(2): 222–7. Disclosure of Interest None declared

Keywords: sclerosis; perfusion; capillaroscopic findings; correlation; systemic sclerosis; patients systemic

Journal Title: Annals of the Rheumatic Diseases
Year Published: 2017

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