title: Peripheral blood perfusion correlates with microvascular abnormalities in systemic sclerosis: a laser-Doppler and nailfold videocapillaroscopy study.
abstract: OBJECTIVE
  To investigate possible correlations between fingertip blood perfusion (FBP) status, assessed by laser Doppler flowmetry (LDF), and morphological microvascular abnormalities, detected by nailfold videocapillaroscopy (NVC), in patients with systemic sclerosis (SSc). The effects on FBP of intravenous (IV) treatment with the prostacyclin analog iloprost were also investigated.
  
  
  METHODS
  Thirty-four consecutive patients with SSc and 16 healthy subjects were evaluated. LDF was performed by analyzing blood perfusion at the fingertips in both hands. Patients with SSc were distributed into the appropriate NVC pattern of microangiopathy (early, active, and late). Iloprost was administered to inpatients with SSc by 24-hour IV infusion for 7 consecutive days (4 microg/h).
  
  
  RESULTS
  FBP was significantly lower in patients with SSc (p < 0.05) compared to controls. Heating of the LDF probe at 36 degrees C induced a significant increase of FBP in all subjects (p < 0.001), but the slope of variation was significantly lower in patients with SSc compared to controls (p < 0.05). Patients with SSc showing the late NVC pattern of microangiopathy had significantly lower FBP than patients with the active and early NVC patterns (p < 0.05). A negative correlation was observed between FBP and NVC rating of the microvascular damage (p < 0.05). After iloprost treatment, a significant increase of FBP was observed in patients with SSc (p < 0.05).
  
  
  CONCLUSIONS
  Patients with SSc show a decreased FBP partially reversible by local skin heating. The FBP correlated negatively with the extent of nailfold microvascular damage, and IV iloprost treatment increased the FBP.
authors.affiliation: Research Laboratory and Academic Unit of Clinical Rheumatology, Department of Internal Medicine, University of Genova, Viale Benedetto XV, no. 6, 16132 Genova, Italy. mcutolo@unige.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cutolo
authors.forename: Carmela
authors.initials: C
authors.lastname: Ferrone
authors.forename: Carmen
authors.initials: C
authors.lastname: Pizzorni
authors.forename: Stefano
authors.initials: S
authors.lastname: Soldano
authors.forename: Bruno
authors.initials: B
authors.lastname: Seriolo
authors.forename: Alberto
authors.initials: A
authors.lastname: Sulli
mesh_terms: D002196:Capillaries / Q000187:drug effects / Q000473:pathology / Q000502:physiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D016285:Iloprost / Q000627:therapeutic use; D007275:Injections, Intravenous; D017078:Laser-Doppler Flowmetry / Q000379:methods*; D008833:Microcirculation / Q000187:drug effects / Q000502:physiology; D020678:Microscopic Angioscopy; D008875:Middle Aged; D009262:Nails / Q000098:blood supply* / Q000187:drug effects; D011928:Raynaud Disease / Q000150:complications / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D012595:Scleroderma, Systemic / Q000150:complications / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D014665:Vasodilator Agents; D016285:Iloprost