AB0771 Abnormal capillaroscopy and pulmonary hypertension in patients with systemic sclerosis

Background Systemic sclerosis (Ss) is an autoimmune disease characterised by microvascular damage with clinical manifestations such as Raynaud Phenomenon, digital ulcers, abnormal capillaroscopy and pulmonary hypertension. Systemic sclerosis is a major risk factor for the development of pulmonary arterial hypertension. Positive capillaroscopy has been associated with involvement of pulmonary vasculature. Objectives To determine if there is association between abnormal capillaroscopy and pulmonary hypertension in patients with systemic sclerosis. Methods Cross-sectional study with a study group of 48 patients with Ss according to ACR/EULAR 2013 criteria; we included a control group with Rheumatoid arthritis patients (RA) and healthy subjects. The peripheral microangiopathy was studied by nailfold capillaroscopy and pulmonary involvement with transthoracic echocardiography. Descriptive statistics with mean and standard deviation were done. We did a chi-square test of homogeneity for groups comparation. Pearson’s test was done for correlation analysis. We used SPSS software for statistics. Results 48 patients with Ss were included, 24 with RA and 24 subjects. 96% were women mean age 48 (±13.6). More frequent co-morbilities were systemic hypertension 17% in Ss vs 25% in RA. The most frequent clinical finding was Raynaud phenomenon in 81% and dysphagia in 67%. 64% of the patients with Ss were positive to anti-centromere antibody. Abnormal capillaroscopy was found in 77% of the Ss patients with the following patterns: early 42%, active 33% and late 23%, also we found abnormal capillaroscopy in 8% of the AR and healthy controls. We found 6% of pulmonary hypertension in Ss 4% was mild and 2% severe. Positive Correlations were Abnormal capillaroscopy and Lung interstitial disease r=0.36 (p=0.009), active pattern r=0.385 (p=0.006), dilated capillaries r=0.457 (p=0.001). The Modified Rodnan score was correlated with: active pattern r=0.525 (p=0.000), dilated capillaries r=0.444 (p=0.001) and avascular areas r=0.495 (p=0.000). We did not find association between abnormal capillaroscopy and pulmonary hypertension r=0.106 (p=0.300) Conclusions We found positive association between abnormal capillaroscopy and interstitial lung disease and no correlation with pulmonary hypertension References [1] Matucci-Cerinic M, Kahaleh B, Wigley FM. Review: Evidence That Systemic Sclerosis Is a Vascular Disease. Arthritis Rheum. 2013; 65 (8):1953–62. [2] Cutolo M, Sulli A, Smith V. Assessing microvascular changes in systemic sclerosis diagnosis and management. Nat Rev Rheumatol. 2010; 6 (10):578–87. [3] Hofstee HMA, Vonk Noordegraaf A, Voskuyl AE, Dijkmans B a. C, Postmus PE, Smulders YM, et al. Nailfold capillary density is associated with the presence and severity of pulmonary arterial hypertension in systemic sclerosis. Ann Rheum Dis. 2009; 68(2):191–5. Disclosure of Interest None declared