Peripheral blood perfusion correlates with microvascular abnormalities in systemic sclerosis: a laser-Doppler and nailfold videocapillaroscopy study.
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.
Cutolo
Maurizio
M
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
Ferrone
Carmela
C
Pizzorni
Carmen
C
Soldano
Stefano
S
Seriolo
Bruno
B
Sulli
Alberto
A
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
D014665:Vasodilator Agents; D016285:Iloprost