title: Quantitative Alterations of Capillary Diameter Have a Predictive Value for Development of the Capillaroscopic Systemic Sclerosis Pattern.
abstract: OBJECTIVE
  To quantify earlier capillary diameter abnormalities, observed by nailfold videocapillaroscopy (NVC), in primary Raynaud phenomenon (PRP) subjects compared with RP subjects later evolved to systemic sclerosis (SSc)-associated secondary Raynaud phenomenon (SRP).
  
  
  METHODS
  There were 6112 NVC images of 191 subjects analyzed at baseline and after a mean followup of 42.77 ± 35.80 months. We selected 48 patients affected by SRP and 143 matched controls confirmed with PRP. The diameter of the most dilated limbs (arterial, venous, and apical) was measured in 16 images per subject. Statistical analysis was performed using nonparametric tests. The threshold values for capillary diameters associated with the development of SSc-associated SRP were determined through receiver-operating characteristic curves.
  
  
  RESULTS
  Mean capillary diameter values were significantly different for arterial, venous, and average diameters (mean value of arterial, venous, and apical) between patients with PRP and SRP (p < 0.0001). These alterations were found to be independent predictors for disease development (p = 0.015). Threshold values of 30 µm (area under the curve = 0.802, sensitivity/specificity = 0.85/0.63) to 31 µm were identified for average, arterial, and venous diameters, with a shortening effect on time to disease development.
  
  
  CONCLUSIONS
  The study showed that capillary diameter is an independent predictor for development of SSc-associated SRP. Progression to SRP is unlikely for subjects affected by RP when average capillary diameter is under 30 μm. Subsequently, the execution of the qualitative/quantitative integrated analysis should be part of the NVC followup of RP subjects.
authors.affiliation: From the Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Genoa, Italy; Department of Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium.A.C. Trombetta, MD, PhD, Trainee in Clinical and Experimental Immunology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; V. Smith, MD, Associate Professor of Rheumatology, Department of Rheumatology, Ghent University Hospital, Ghent University; C. Pizzorni, MD, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Meroni, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; S. Paolino, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; C. Cariti, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; B. Ruaro, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; A. Sulli, MD, Associate Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Cutolo, MD, Full Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa.
authors.forename: Amelia Chiara
authors.initials: AC
authors.lastname: Trombetta
authors.affiliation: From the Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Genoa, Italy; Department of Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium.A.C. Trombetta, MD, PhD, Trainee in Clinical and Experimental Immunology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; V. Smith, MD, Associate Professor of Rheumatology, Department of Rheumatology, Ghent University Hospital, Ghent University; C. Pizzorni, MD, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Meroni, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; S. Paolino, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; C. Cariti, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; B. Ruaro, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; A. Sulli, MD, Associate Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Cutolo, MD, Full Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Smith
authors.affiliation: From the Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Genoa, Italy; Department of Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium.A.C. Trombetta, MD, PhD, Trainee in Clinical and Experimental Immunology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; V. Smith, MD, Associate Professor of Rheumatology, Department of Rheumatology, Ghent University Hospital, Ghent University; C. Pizzorni, MD, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Meroni, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; S. Paolino, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; C. Cariti, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; B. Ruaro, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; A. Sulli, MD, Associate Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Cutolo, MD, Full Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa.
authors.forename: Carmen
authors.initials: C
authors.lastname: Pizzorni
authors.affiliation: From the Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Genoa, Italy; Department of Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium.A.C. Trombetta, MD, PhD, Trainee in Clinical and Experimental Immunology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; V. Smith, MD, Associate Professor of Rheumatology, Department of Rheumatology, Ghent University Hospital, Ghent University; C. Pizzorni, MD, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Meroni, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; S. Paolino, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; C. Cariti, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; B. Ruaro, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; A. Sulli, MD, Associate Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Cutolo, MD, Full Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa.
authors.forename: Marianna
authors.initials: M
authors.lastname: Meroni
authors.affiliation: From the Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Genoa, Italy; Department of Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium.A.C. Trombetta, MD, PhD, Trainee in Clinical and Experimental Immunology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; V. Smith, MD, Associate Professor of Rheumatology, Department of Rheumatology, Ghent University Hospital, Ghent University; C. Pizzorni, MD, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Meroni, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; S. Paolino, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; C. Cariti, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; B. Ruaro, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; A. Sulli, MD, Associate Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Cutolo, MD, Full Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Paolino
authors.affiliation: From the Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Genoa, Italy; Department of Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium.A.C. Trombetta, MD, PhD, Trainee in Clinical and Experimental Immunology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; V. Smith, MD, Associate Professor of Rheumatology, Department of Rheumatology, Ghent University Hospital, Ghent University; C. Pizzorni, MD, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Meroni, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; S. Paolino, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; C. Cariti, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; B. Ruaro, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; A. Sulli, MD, Associate Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Cutolo, MD, Full Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa.
authors.forename: Caterina
authors.initials: C
authors.lastname: Cariti
authors.affiliation: From the Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Genoa, Italy; Department of Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium.A.C. Trombetta, MD, PhD, Trainee in Clinical and Experimental Immunology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; V. Smith, MD, Associate Professor of Rheumatology, Department of Rheumatology, Ghent University Hospital, Ghent University; C. Pizzorni, MD, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Meroni, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; S. Paolino, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; C. Cariti, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; B. Ruaro, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; A. Sulli, MD, Associate Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Cutolo, MD, Full Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa.
authors.forename: Barbara
authors.initials: B
authors.lastname: Ruaro
authors.affiliation: From the Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Genoa, Italy; Department of Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium.A.C. Trombetta, MD, PhD, Trainee in Clinical and Experimental Immunology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; V. Smith, MD, Associate Professor of Rheumatology, Department of Rheumatology, Ghent University Hospital, Ghent University; C. Pizzorni, MD, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Meroni, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; S. Paolino, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; C. Cariti, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; B. Ruaro, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; A. Sulli, MD, Associate Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Cutolo, MD, Full Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa.
authors.forename: Alberto
authors.initials: A
authors.lastname: Sulli
authors.affiliation: From the Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Genoa, Italy; Department of Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium.A.C. Trombetta, MD, PhD, Trainee in Clinical and Experimental Immunology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; V. Smith, MD, Associate Professor of Rheumatology, Department of Rheumatology, Ghent University Hospital, Ghent University; C. Pizzorni, MD, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Meroni, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; S. Paolino, PhD, Assistant Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; C. Cariti, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; B. Ruaro, MD, Trainee in Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; A. Sulli, MD, Associate Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa; M. Cutolo, MD, Full Professor of Rheumatology, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa. mcutolo@unige.it.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cutolo
mesh_terms: D000328:Adult; D000368:Aged; D002196:Capillaries / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D020678:Microscopic Angioscopy; D008875:Middle Aged; D011237:Predictive Value of Tests; D012595:Scleroderma, Systemic / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity
keywords: EARLY DIAGNOSIS; EARLY SCLERODERMA PATTERN; MICROVASCULAR DISEASE; NAILFOLD VIDEOCAPILLAROSCOPY; RAYNAUD PHENOMENON; SYSTEMIC SCLEROSIS