Nailfold video-capillaroscopy in the study of cardiovascular disease: a systematic review

Lim, M. W.S., Setjiadi, D., Dobbin, S. J.H., Lang, N. N. , Delles, C. and Connelly, P. J. (2023) Nailfold video-capillaroscopy in the study of cardiovascular disease: a systematic review. Blood Pressure Monitoring, 28(1), pp. 24-32. (doi: 10.1097/MBP.0000000000000624) (PMID:36281701) (PMCID:PMC9815820)

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Objectives: Nailfold video-capillaroscopy (NVC) is an inexpensive method of assessing microcirculation. We reviewed the literature to assess whether changes to the nailfold capillaries exist in patients with cardiovascular disease (CVD). Methods: We searched PubMed, Scopus and Cochrane Library databases for original research articles relating to the use of noninvasive microvascular assessment in patients with CVD. Methodological quality was assessed with the ‘Quality Assessment Tool for Observational Cohort and Cross-sectional Studies.’ The results obtained from NVC were analysed qualitatively and compared with other forms of microvascular assessment. Results: In total 2759 articles were screened, of which 22 studies involving 562 patients (~40% women) with CVD were included. Mean age ranged between 3.7–68.4 years (cases) and 4.0–58.0 years (controls). Reduced capillary density and increased capillary dimensions were seen in patients with pulmonary arterial hypertension (PAH). Among patients with systemic sclerosis, advanced scleroderma patterns can be used to identify patients with or at risk of developing PAH. Functional nailfold changes precede structural changes in patients with hypertension. However, the studies were heterogeneous in the diagnosis of disease and the measurement of nailfold parameters. Most studies did not exclude conditions with altered nailfold features, and only one study performed a power calculation. Furthermore, abnormal nailfold findings are present in patients without systemic disease. Conclusions: Structural and functional changes to the nailfold are a feature of established CVD and precede the development of PAH. However, heterogeneity in measurement and abnormal findings in healthy participants limit their use in the wider population.

Item Type:Articles
Additional Information:ML has been supported by the James Patterson Bursary, DS by the Horizon 2020 Framework Programme (No 954798), and SD, NL, CD and PC by the British Heart Foundation Centre of Research Excellence Award (RE/18/6/34217).
Glasgow Author(s) Enlighten ID:Lang, Professor Ninian and Setjiadi, Ms Dellaneira and Delles, Professor Christian and Connelly, Dr Paul
Authors: Lim, M. W.S., Setjiadi, D., Dobbin, S. J.H., Lang, N. N., Delles, C., and Connelly, P. J.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Blood Pressure Monitoring
Publisher:Lippincott, Williams & Wilkins
ISSN (Online):1473-5725
Published Online:20 October 2022
Copyright Holders:Copyright © 2022 The Author(s)
First Published:First published in Blood Pressure Monitoring 28(1): 24-32
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
310295MINDSHIFTRhian TouyzEuropean Commission (EC)954798CS - Epigenetics
303944BHF Centre of ExcellenceColin BerryBritish Heart Foundation (BHF)RE/18/6/34217CAMS - Cardiovascular Science