Relationship between nailfold videocapillaroscopic findings and cardiovascular risk factors

Eva Álvarez Andrés; Eugenio de Miguel; María Jesús García de Yébenes; Loreto Carmona; Cristina Gómez Miranda; Paz Collado Ramos; Paloma García de la Peña Lefebvre

doi:10.1016/j.mvr.2024.104693

Relationship between nailfold videocapillaroscopic findings and cardiovascular risk factors

Microvasc Res. 2024 May 1:154:104693. doi: 10.1016/j.mvr.2024.104693. Online ahead of print.

Authors

Eva Álvarez Andrés¹, Eugenio de Miguel², María Jesús García de Yébenes³, Loreto Carmona³, Cristina Gómez Miranda⁴, Paz Collado Ramos⁵, Paloma García de la Peña Lefebvre⁶

Affiliations

¹ Autonomous University of Madrid, Severo Ochoa University Hospital, Rheumatology Department, ciudad universitaria cantoblanco, Avda de Orellana s/n, Madrid, Spain. Electronic address: evap.alvarez@estudiante.uam.es.
² Autonomous University of Madrid, La Paz University Hospital, Rheumatology Department, ciudad universitaria cantoblanco, Paseo de la castellana, 261 Madrid, Spain.
³ Department Institute of Musculoskeletal Health (InMusc), c/Mendez Álvaro, 20, Madrid, Spain.
⁴ Image Radiology Center Dr. Gomez Pereda, c/ Elvira de Hidalgo 6-8, Zaragoza, Spain.
⁵ Severo Ochoa University Hospital, Rheumatology Department, Avda de Orellana s/n, Madrid Spain.
⁶ Faculty of Health Sciences of HM Hospitals, Camilo José Cela University, c/castillo de Alarcón, 49, Madrid, Spain.

PMID: 38701966
DOI: 10.1016/j.mvr.2024.104693

Abstract

Background: Nailfold Videocapillaroscopy (NVC) is a valuable tool in the differential diagnosis of Raynaud's phenomenon (RP), present in certain Rheumatic diseases (RD). Knowing that many people have cardiovascular risk factors (CVRF), the main objective was to demonstrate that CVRF and carotid plaques produce NVC alterations.

Methods: Cross-sectional unicentric study carried out from 2020 to 2023. Four groups were formed: subjects with RD and RP, participants with RD without RP, subjects with RP without RD and finally participants without RP or RD (study group). Each subject exhibiting CVRF presented only a single risk factor. The variables collected were: sociodemographic, CVRF (diabetes, tobacco, alcohol (ALC), obesity (OBE), dyslipidemia and arterial hypertension (AH)), diseases, RP, treatments, tortuosities and NVC alterations (ramified capillaries, enlarged capillaries, giant capillaries, haemorrhages and density loss) and carotid ultrasound (CU).

Results: 402 subjects were included (76 % women, mean age 51 ± 16 years), 67 % had CVRF, 50 % RP and 38 % RD. Tortuosities were present in 100 % of CVRF participants. A statistically significant association was found between the presence of CVRF and all the NVC alterations: ramified capillaries (OR = 95.6), enlarged capillaries (OR = 59.2), giant capillaries (OR = 8.32), haemorrhages (OR = 17.6) and density loss (OR = 14.4). In particular, an association was found between giant capillaries with AH (p = 0,008) and OBE (p 〈0,001), and haemorrhages and density loss with ALC and OBE (p < 0,001). On the other hand, 40 subjects presented CU plaques (9.9 %), associated with enlarged capillaries (OR = 8.08), haemorrhages (OR = 4.04) and ramified capillaries (OR = 3.01). The pathological intima-media thickness was also associated with haemorrhages (OR = 3.14).

Conclusions: There is a clear association between CVRF and ultrasound atherosclerotic findings in carotid with NVC alterations. These findings are of special interest for a correct NVC interpretation and to avoid false positives in the diagnosis of primary and secondary RP.

Keywords: Capillaroscopy; Cardiovascular risk factors; Carotid ultrasound; Nailfold Videocapillaroscopy.