Association between endothelial function and microvascular changes in patients with secondary Raynaud's phenomenon

Area of Science:

• Rheumatology
• Vascular Biology
• Microcirculation

Background:

• Nailfold capillaroscopy (NC) is crucial for assessing microvascular changes in autoimmune rheumatic diseases.
• The pathophysiological link between NC findings and endothelial function in Raynaud's phenomenon (RP) remains unclear.
• Understanding this link is vital for diagnosing and managing autoimmune conditions affecting the microvasculature.

Purpose of the Study:

• To investigate the association between endothelial function and microvascular derangement in patients with secondary Raynaud's phenomenon (RP).
• To compare microvascular alterations and endothelial function between postmenopausal women with secondary RP and healthy controls.

Main Methods:

• Evaluated 37 postmenopausal women with secondary RP and 25 age-matched healthy controls using NC.
• Assessed microvascular alterations via microangiopathy evolution score.
• Examined endothelial function using brachial artery flow-mediated dilatation (reactive FMD) and nitroglycerin-induced dilatation (NTG).

Main Results:

• Patients with secondary RP exhibited significant capillary loop dilatation and lengthening compared to controls.
• Prevalence of giant capillaries, capillary loss, hemorrhage, and background pallor was higher in the secondary RP group.
• Endothelial function was significantly impaired in secondary RP, indicated by reduced reactive FMD values.

Conclusions:

• Significantly impaired endothelial function is present in patients with secondary RP.
• Microvascular derangements observed via NC are associated with endothelial dysfunction in secondary RP.
• NC findings correlate with impaired endothelial function, highlighting its role in the pathophysiology of secondary RP.