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Does sublingual microscopy correlate with nailfold videocapillaroscopy in systemic sclerosis?
Mislav Radic1,2, Julie Thomas1, Sean McMillan1
1Department of Internal Medicine, Division of Rheumatology, University of Utah, 1900 E 30N, SOM 4b200, Salt Lake City, UT, 84132, USA.
Clinical Rheumatology
|January 8, 2021
Summary
Sublingual videomicroscopy and nailfold videocapillaroscopy (NVC) show significant correlation in assessing microvascular changes in systemic sclerosis (SSc). These findings support using these non-invasive tools for monitoring SSc vasculopathy over time.
Area of Science:
- Vascular Biology
- Rheumatology
- Medical Imaging
Background:
- Systemic sclerosis (SSc) is characterized by microvascular abnormalities, making tools to assess vasculopathy crucial for patient monitoring.
- Longitudinal assessment of microvascular function and morphology is important for managing SSc.
- Current methods for evaluating SSc vasculopathy require further validation with non-invasive techniques.
Purpose of the Study:
- To examine the correlation between sublingual videomicroscopy and nailfold videocapillaroscopy (NVC) in patients with systemic sclerosis (SSc).
- To assess the utility of sublingual videomicroscopy as a non-invasive tool for monitoring microvascular changes in SSc.
- To determine if sublingual microvascular density correlates with specific nailfold findings and microangiopathy evolution scores.
Main Methods:
- Sublingual videomicroscopy and NVC were performed on 39 SSc patients meeting classification criteria.
- Sublingual assessment measured microvascular density, red blood cell fraction (RBC fract), and perfused boundary region (PBR).
- NVC evaluated nailfold findings, categorizing them into normal, early, active, late scleroderma patterns, or non-specific changes. A microangiopathy evolution score was calculated.
Main Results:
- A highly significant association was found between total sublingual microvascular density and capillary number by NVC (r=0.569, P=0.0002).
- Statistically significant negative correlations were observed between sublingual microvascular density and microangiopathy evolution score (r=0.532, P=0.0006), vascular disorganization (r=0.461, P=0.003), and giant capillaries (r=0.387, P=0.01).
- No correlation was found between RBC fract or PBR and NVC parameters.
Conclusions:
- Sublingual videomicroscopy and NVC demonstrate significant correlation in assessing microvascular density and disease progression in SSc.
- These findings support the serial use of non-invasive sublingual microvascular function testing for clinical monitoring of SSc vasculopathy.
- Both nailfold and sublingual microscopy can identify capillary density loss in SSc patients, aiding in disease management.
