Ultrasound Classification of Finger Pulp Blood Flow in Patients With Systemic Sclerosis: A Pilot Study.

Autor: Lescoat A; Department of Internal Medicine and Clinical Immunology, CHU Rennes, University of Rennes and CHU Rennes, INSERM, EHESP, Institut de recherche en santé, environnement et travail, UMR S 1085, Rennes, France., Robin F; Department of Rheumatology, CHU Rennes, University of Rennes and INSERM, University of Rennes, INRA, CHU Rennes, Institut NUMECAN, Rennes, France., Belhomme N; Department of Internal Medicine and Clinical Immunology, CHU Rennes, University of Rennes and CHU Rennes, INSERM, EHESP, Institut de recherche en santé, environnement et travail, UMR S 1085, Rennes, France., Ballerie A; Department of Internal Medicine and Clinical Immunology, CHU Rennes, University of Rennes and CHU Rennes, INSERM, EHESP, Institut de recherche en santé, environnement et travail, UMR S 1085, Rennes, France., de Saint Riquier M; Department of Rheumatology, CHU Rennes, University of Rennes, Rennes, France., Sebillot M; Department of Internal Medicine and Clinical Immunology, CHU Rennes, University of Rennes, Rennes, France., Albert JD; Department of Rheumatology, CHU Rennes, University of Rennes and INSERM, University of Rennes, INRA, CHU Rennes, Institut NUMECAN, Rennes, France., Le Gallou T; Department of Internal Medicine and Clinical Immunology, CHU Rennes, University of Rennes, Rennes, France., Perdriger A; Department of Rheumatology, CHU Rennes, University of Rennes, Rennes, France., Jégo P; Department of Internal Medicine and Clinical Immunology, CHU Rennes, University of Rennes and CHU Rennes, INSERM, EHESP, Institut de recherche en santé, environnement et travail, UMR S 1085, Rennes, France., Coiffier G; Department of Internal Medicine and Clinical Immunology, CHU Rennes, University of Rennes, Rennes, France, and Department of Rheumatology, CH Dinan, Dinan, France., Cazalets C; Department of Internal Medicine and Clinical Immunology, CHU Rennes, University of Rennes, Rennes, France.
Jazyk: angličtina
Zdroj: Arthritis care & research [Arthritis Care Res (Hoboken)] 2023 Feb; Vol. 75 (2), pp. 299-306. Date of Electronic Publication: 2022 Sep 22.
DOI: 10.1002/acr.24779
Abstrakt: Objective: To define a semiquantitative classification of finger pulp blood flow (FPBF) and to evaluate whether this classification could be used to assess FPBF in healthy controls and in systemic sclerosis (SSc) patients.
Methods: Thirty controls and 86 SSc patients were consecutively included. A classification of FPBF including 5 grades (from grade 0 [no signal] to 4 [signal detected on the entire finger pulp, including the subepidermal vascular network]) was evaluated. This classification was explored in basal conditions and after hand baths in hot and cold water in controls. Its relevance was also assessed at room temperature in SSc patients.
Results: In controls, power Doppler ultrasonography (PDUS) of FPBF was improved after hot challenge (P = 0.024), whereas cold challenge decreased FPBF (P = 0.001). FPBF correlated with the vasodilation status assessed by the resistivity index of radial arteries (Spearman's correlation coefficient = -0.50, P = 0.0049). Grade 0 was more frequent in SSc patients than in controls (22.1% versus 3.3%; P < 0.05). In SSc patients, grade 0 was associated with severity markers of the digital vasculopathy such as digital ulcers (DUs) (current or past) (P < 0.05) or ulnar artery occlusion (P < 0.05). On the other hand, DUs were less frequent in patients with grade 4 (P < 0.05). A pathologic threshold of <2 (grade 0 or 1) was significantly associated with DUs (odds ratio 6.67 [95% confidence interval 2.31-19.21], P < 0.0001).
Conclusion: PDUS allowed a semiquantitative evaluation of FBPF in SSc patients and controls. Further studies are warranted to validate these results in independent SSc populations and to compare PDUS to existing tools assessing digital blood flow.
(© 2021 American College of Rheumatology.)
Databáze: MEDLINE
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