Rheumatology strives to support research and discovery by publishing the highest quality original scientific papers with a focus on basic, clinical and translational research. The journal’s subject areas cover a wide range of paediatric and adult rheumatological conditions from an international perspective. It is an official journal of the British Society for Rheumatology, published by Oxford University Press. Rheumatology publishes original articles, reviews, editorials, guidelines, concise reports, meta-analyses, original case reports, clinical vignettes, letters and matters arising from published material. The journal takes pride in serving the global rheumatology community, with a focus on high societal impact in the form of podcasts, videos and extended social media presence, and utilizing metrics such as Altmetric. Keep up to date by following the journal on Twitter @RheumJnl.
Anna Ghirardello, Mariaelisa Rampudda, Louise Ekholm, Nicola Bassi, Elena Tarricone, Sandra Zampieri, Margherita Zen, Gaetano Vattemi, Ingrid E. Lundberg, Andrea Doria
Isidoro González‐Álvaro, Carmen Martínez, Benito Dorantes-Calderón, Rosario García‐Vicuña, Blanca Hernández‐Cruz, Alicia Herrero-Ambrosio, Olatz Ibarra Barrueta, E. Martín‐Mola, Emilio Monte‐Boquet, Alberto Morell‐Baladrón, Raimón Sanmartí, Jesús Sanz, Francisco Javier de Toro Santos, Paloma Vela, Jose Andrés Román Ivorra, José Luís Poveda-Andrés, Santiago Muñóz-Fernández
AbstractObjectivesSystemic vasculitides (SVs) are a highly inflammatory group of diseases characterized by significant cardiovascular (CV) mortality. Microvascular damage closely linked with accelerated atherosclerosis and thrombosis represents a core pathophysiological mechanism contributing to the excess CV risk of patients with SVs. Skin represents an easily accessible tissue facilitating non-invasive microvascular study. In this study we aimed to investigate microcirculation dynamics and associate them with disease-related factors in patients with SVs.MethodsWe assessed skin microcirculation using laser speckle contrast imaging (LSCI) and vascular reactivity by the post-occlusive reactive hyperaemia (PORH) protocol in a meticulously selected group of patients with SVs without CV disease and compared them to controls, matched for age, sex, BMI and smoking status.ResultsSixty individuals were included in the study, 30 patients and 30 controls. Patients with SVs presented a lower peak magnitude during reperfusion phase (median [interquartile range] 207 [60.1] vs 143.7 [41.0] laser speckle perfusion units, P < 0.001) and lower percentage cutaneous vascular conductance increase (mean (s.d.) 190.0 [49.6]% vs 149.6 [48.9]%, P = 0.002) as compared with controls. Importantly, microvascular damage was correlated with disease duration (P < 0.001, r = −0.563 and P < 0.001, r = 0.442, respectively).ConclusionFor the first time we have shown that patients with SVs exhibit impaired microvascular function and blunted reactivity after occlusion, as this was demonstrated by the LSCI technique. Therefore, skin microcirculation may be a useful, non-invasive method in patients with SVs for the early detection of microvascular dysfunction, which is closely related to the high CV risk that these patients bear.
AbstractObjectivesPatients with SLE have increased cardiovascular mortality. Alterations in both macro- and micro-circulation have been associated with cardiovascular disease. We sought to assess skin microvascular function by using laser speckle contrast analysis (LASCA) in patients with SLE, with and without cardiovascular disease and risk factors.MethodsContinuous blood flow was recorded using a LASCA device during baseline, a 5-min arterial occlusion and a 5-min reperfusion period.ResultsThirty-five patients with SLE (85.7% women) with a median disease duration 12.0 (6.5–17.5) years and a mean age of 46.3 (8.6) years and 31 controls matched for age, sex and BMI were enrolled. During reperfusion, SLE patients exhibited a smaller peak magnitude compared with controls (161.0 (47.1) vs 197.2 (41.4)%, respectively, P =0.002). Results remained unchanged among 24 SLE patients without cardiovascular disease compared with the control group (169.2 (48.1) vs 195.6 (34.0)%, respectively, P =0.002).ConclusionOur study shows, for the first time, that patients with SLE, even without overt cardiovascular disease or risk factors, exhibit a blunted microvascular reactivity during reperfusion compared with controls. These results show that skin microvascular dysfunction is present in SLE independently of the CV burden that these patients bear and may represent an early sign of vascular damage.
Alessandro Zerbini, Francesco Muratore, Luigi Boiardi, Francesco Ciccia, Martina Bonacini, L Belloni, Alberto Cavazza, Luca Cimino, Antonio Moramarco, Riccardo Alessandro, Aroldo Rizzo, Maria Parmeggiani, Carlo Salvarani, Stefania Croci
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