A Nailfold Capillaroscopy Study in Patients with Systemic Sclerosis and Pulmonary Hypertension

Background: Systemic sclerosis is a disease characterized by several vascular abnormalities among which pulmonary hypertension represents a serious problem of morbidity and mortality in the evolution. The aim of the present study was to assess the correlation between pulmonary function parameters and nailfold capillaroscopy findings in patients diagnosed with systemic sclerosis and pulmonary arterial hypertension. Material and methods: Fifteen patients with systemic sclerosis and pulmonary arterial hypertension were included in this study. The parameters assessed were as follows: pulmonary artery systolic pressure (PASP), forced vital capacity (FVC), forced expiratory volume in 1 sec/forced vital capacity ratio (FEV1/FVC ratio), and the number of nailfold capillaries/mm. Data are presented as mean +/- standard deviation. Statistical analyses were performed using the Student's t-test and the Pearson's correlation. Differences were considered statistically significant at p<0.05. Results: Mean age of patients was 48.66 +/- 6.51 years and the mean duration of the disease, 5.86 +/- 3.34 years. Among them, 9 had diffuse systemic sclerosis whereas 6 patients had the limited form of the disease. The values of recorded parameters were: 49.73 +/- 13.03 mmHg (PASP), 4.49 +/- 1.95 capillaries/mm, 67.33 +/- 10.84% (FVC), and 78.53 +/- 4.8% (FEV1/FVC ratio), respectively. We report a significant correlation between the number of nailfold capillaries/mm and PASP (p = 0.00044) in both types of disease. However, correlation between the number of capillaries/mm and FVC was found significant (p = 0.0001) only in patients with diffuse systemic sclerosis. Conclusion: In patients with systemic sclerosis, our preliminary data show a severity-dependent correlation of pulmonary arterial hypertension and FVC with the capillaroscopic findings.