[Usefulness of photoplethysmography and indexes of digital pressure in Raynaud phenomenon].
BACKGROUND
To know the usefulness of plethysmography and digital pressure indexes (DPI) to assess the vasospasm and the response to medical treatment in patients with Raynaud's phenomenon.


METHODS
During a four-month period, we carried out a prospective clinical trial, with a control group (15 subjects) and other of patients with Raynaud's phenomenon (40 patients). We calculated the digital pressures, plethysmography and the DPI, in basal status and after provocation with cold water. The Raynaud's group was divided randomly in two homogeneous subgroups of 20 subjects. One of the groups underwent treatment with calcium antagonists and the other group with placebo. These determinations were repeated at the middle and at the end of the treatment.


RESULTS
The basal DPI and after provocation test were lower in the Raynaud's group (0.61 [SD 0.26] and 0.25 [SD 0.26]), than in the control group (0.93 [SD 0.06] and 0.88 [SD 0.07]), with a statistical significance (p < 0.001 and p < 0.0001). After the treatment, in the subgroup treated with calcium antagonists, the DPI were increased in a statistically significative way respect to those in the placebo subgroup (p < 0.0001). Sensitivity and specificity of the DPI associated to the provocation test were of 97 and 93%, respectively. The plethysmographic wave did not suffer significant variations; sensibility and specificity were 48 and 100%.


CONCLUSIONS
In the Raynaud's phenomenon the DPI associated to the provocation test have a high sensitivity and specificity, and allows determination of the degree of vasospasm and the response to treatment.
Martínez
S
S
Servicio de Angiología y Cirugía Vascular, Hospital Son Dureta, Palma de Mallorca.
Lozano
P
P
Pallarés
L
L
Juliá
J
J
Artigues
I
I
Plaza
A
A
Rimbau
E M
EM
Corominas
C
C
Gómez
F T
FT
D000328:Adult; D001795:Blood Pressure Determination / Q000379:methods*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004311:Double-Blind Method; D015736:Felodipine / Q000627:therapeutic use; D005260:Female; D005385:Fingers / Q000098:blood supply; D006801:Humans; D008297:Male; D017156:Photoplethysmography; D011446:Prospective Studies; D011928:Raynaud Disease / Q000175:diagnosis* / Q000188:drug therapy; D012680:Sensitivity and Specificity
D002121:Calcium Channel Blockers; D015736:Felodipine