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Dermal capillary rarefaction as a marker of microvascular damage in patients with rheumatoid arthritis: Association with inflammation and disorders of the macrocirculation
Author(s) -
Anyfanti Panagiota,
Gkaliagkousi Eugenia,
Triantafyllou Areti,
Zabulis Xenophon,
Dolgyras Panagiotis,
Galanopoulou Vasiliki,
Aslanidis Spyros,
Douma Stella
Publication year - 2018
Publication title -
microcirculation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.793
H-Index - 83
eISSN - 1549-8719
pISSN - 1073-9688
DOI - 10.1111/micc.12451
Subject(s) - medicine , cardiology , microcirculation , rheumatoid arthritis , arterial stiffness , inflammation , endothelial dysfunction , framingham risk score , disease , blood pressure
Objective Capillary rarefaction is observed in various cardiovascular diseases, yet it remains understudied in RA , a chronic inflammatory disease accompanied by excess cardiovascular risk. We quantified capillary density in RA patients and explored potential associations with macrocirculatory disorders, inflammation, and cardiovascular risk. Methods Dermal capillary density was assessed with nailfold capillaroscopy in RA and non‐ RA individuals, using specifically designed semiautomated software. Macrocirculation assessments included large artery stiffening, evaluated with PWV , and myocardial blood flow, calculated as cardiac index from impedance cardiography. Cardiovascular risk score was estimated from the Framingham Heart Study. Results The number of capillaries per visual field was lower in patients (n = 99) compared to controls (n = 35) (132.6 ± 30.3 vs 152.9 ± 25.2, P = .001). In the RA group, capillary density negatively correlated with CRP and PWV , and positively with HDL and cardiac index. In the multivariate analysis, CRP independently predicted capillary rarefaction ( P = .044). Capillary density significantly correlated with cardiovascular risk, even after adjustment for inflammation ( P = .030). Conclusion Capillary rarefaction appears pronounced in RA and correlates with lower cardiac output, increased arterial stiffness, and cardiovascular risk. However, the associations with macrocirculatory disorders may be obscured by inflammation, which appears as the major contributor to capillary rarefaction in RA .