Abstract Background Nailfold capillaroscopy (NFC) is a noninvasive, readily accessible method that is highly valuable for the diagnosis of both primary and secondary Raynaud’s phenomenon. Hence, to identify distinct nailfold capillaroscopy patterns in some autoimmune diseases and to identify disease-related variations in the prevalence and severity of coronary microvascular dysfunction (CMD) by considering the systemic involvement of the microvessels in those patients, we conducted this study on 150 patients of various autoimmune diseases (50 psoriatic arthritis (PSA), 50 rheumatoid arthritis (RA), and 50 systemic sclerosis (SSc) patients) in addition to 100 healthy individuals age- and sex-matched to patient groups as controls. The recruited subjects had no evidence of cardiovascular disease. All patients were subjected to clinical laboratory and NFC assessments. Fractional coronary flow reserve (FCFR) was calculated using coronary CT angiography, and echocardiography was utilized to assess early CMD. Results A higher prevalence of reduced FCFR was observed in all patients when compared to controls (0.62 ± 0.03, 0.68 ± 0.02 and 0.65 ± 0.02 vs 0.8 ± 0.30), respectively. CMD was detected in 35 PSA patients (68%), 30 (60%) RA patients, and 40 (80%) SSc patients vs 0 control ( p < 0.014). FCFR was significantly correlated with density and capillary ramifications scores ( p < 0.001, p < 0.001) in SSc patients. Avascular, ramification scores and capillary width ( p < 0.001, p < 0.001, and < 0.05, respectively) in PSA and capillary width and length ( p < 0.05 and p < 0.05) in RA patients were higher in patients with CMD than in those without. Conclusions Nailfold capillaroscopy patterns and scores in various autoimmune diseases were associated with coronary microvascular dysfunction which seems to be the result of a structural microvascular remodeling.
Nada et al. (Mon,) studied this question.