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Abnormal peripheral microcirculation by nailfold videocapillaroscopy reveals severity of atherosclerosis in coronary
Yanan Chen1, Mengmeng Ren1, Chunxiao Wang2
1Department of Cardiology, Yantai Yuhuangding Hospital, Yantai, 264000, Shandong, China.
Insights
Peripheral microangiopathy, characterized by reduced capillary length and increased thrombosis, is present in coronary heart disease (CHD) patients. These microcirculatory changes correlate with CHD severity, suggesting potential for screening.
Area of Science:
- Cardiovascular Medicine
- Microcirculation Research
- Diagnostic Biomarkers
Background:
- Peripheral microangiopathy is observed in various conditions.
- Its presence in coronary heart disease (CHD) remains unclear.
- Investigating microcirculatory changes in CHD patients is crucial.
Purpose of the Study:
- To determine if peripheral microcirculation changes are present in patients with coronary heart disease (CHD).
- To assess the correlation between peripheral microangiopathy and CHD severity.
- To explore the utility of peripheral microangiopathy as a potential biomarker for CHD.
Main Methods:
- Nail fold videocapillaroscopy was performed on 219 patients, divided into control and CHD groups.
- Propensity score matching (1:1 ratio) was employed to balance group characteristics.
- Peripheral microangiopathy parameters were compared, and correlations with CHD severity were analyzed.
Main Results:
- Patients with CHD exhibited reduced capillary length, increased thrombosis, and abnormal papilla/subpapillary venous plexuses compared to controls.
- CHD severity positively correlated with crossed capillaries, thrombosis, abnormal papilla, and overall scores.
- Post-matching analysis confirmed reduced apical width and capillary length, with increased abnormal plexuses and total scores in CHD patients.
Conclusions:
- Peripheral microangiopathy is evident in patients with coronary heart disease.
- Microcirculatory alterations correlate significantly with CHD severity.
- Peripheral microangiopathy shows promise as a tool for CHD screening and assessment.
Abstract:
Background Peripheral microangiopathy occurs in various diseases. However it is not known whether changes in the peripheral microcirculation are present in patients with coronary heart disease (CHD). Methods Two hundred and nineteen patients were enrolled. They were allocated to a control group and a CHD group according to coronary angiography findings and underwent nail fold videocapillaroscopy. Propensity score matching was used to match the two groups in a 1:1 ratio. Peripheral microangiopathy parameters were compared between the groups, and correlation were assessed between changes in the peripheral microcirculation and the severity of CHD. Results Overall, 95 patients were included in the control group and 124 in the CHD group. Patients in the CHD showed reduced capillary lengths, increased thrombosis, abnormal papilla and subpapillary venous plexuses, and a higher proportion of total score 2 compared with the controls. CHD severity was positively correlated with the numbers of crossed capillaries, thrombosis, abnormal papilla and total Score 2. After propensity score matching analysis, reduced apical width and capillary length were observed, while abnormal papillary and subpapillary venous plexuses were increased in patients with CHD, together with increases in the total scores. Conclusion The findings demonstrated that the effectiveness of peripheral microangiopathy in assessing CHD severity, providing a basis for CHD screening.
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