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Review

Nailfold Capillaroscopy in Systemic Sclerosis Patients with and without Pulmonary Arterial Hypertension: A Systematic Review and Meta-Analysis

1
Fourth Department of Internal Medicine, Hippokration University Hospital, Medical School, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
2
Department of Nephrology, Hippokration University Hospital, Medical School, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
3
Department of Respiratory Medicine, G. Papanikolaou Hospital, 57010 Pylaia-Chortiatis, Greece
4
Adult Congenital Heart Centre and National Centre for Pulmonary Arterial Hypertension, Royal Brompton Hospital, Guy’s and St Thomas’ NHS Foundation Trust, Imperial College, London SW3 6NP, UK
5
Department of Respiratory Failure, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, 57010 Pylaia-Chortiatis, Greece
6
Second Propedeutic Department of Internal Medicine, Hippokration University Hospital, Medical School, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
*
Author to whom correspondence should be addressed.
Academic Editor: George Giannakoulas
J. Clin. Med. 2021, 10(7), 1528; https://doi.org/10.3390/jcm10071528
Received: 28 February 2021 / Revised: 3 April 2021 / Accepted: 5 April 2021 / Published: 6 April 2021
(This article belongs to the Special Issue Pulmonary Hypertension: Current Diagnosis Approach and Treatment)
Systemic sclerosis (SSc)-related pulmonary arterial hypertension (SSc-PAH) is a leading cause of mortality in SSc. The extent of peripheral microvasculopathy assessed through nailfold capillaroscopy might correlate with the presence of PAH in SSc patients. We searched the PubMed, Cochrane Library, Scopus, and Web of Science databases and performed a random effects meta-analysis of observational studies comparing nailfold capillaroscopic alterations in SSc-PAH versus SSc-noPAH patients. Weighted mean differences (WMD) with the corresponding confidence intervals (CIs) were estimated. The quality of the included studies was evaluated using a modified Newcastle–Ottawa scale. Seven studies with 101 SSc-PAH and 277 SSc-noPAH participants were included. Capillary density was marginally reduced in the SSc-PAH group (WMD: −1.0, 95% CI: −2.0 to 0.0, I2 = 86%). This effect was strengthened once PAH diagnosis was confirmed by right heart catheterization (WMD: −1.2, 95% CI: −2.3 to −0.1, I2 = 85%). An increase in capillary loop width was observed in SSc-PAH compared to SSc-noPAH patients (WMD: 10.9, 95% CI: 2.5 to 19.4, I2 = 78%). Furthermore, SSc-PAH patients had a 7.3 times higher likelihood of active or late scleroderma pattern (95% CI: 3.0 to 18.0, I2 = 4%). SSc-PAH patients presented with worse nailfold capillaroscopic findings compared to SSc-noPAH patients. View Full-Text
Keywords: pulmonary arterial hypertension; systemic sclerosis; nailfold capillaroscopy; meta-analysis pulmonary arterial hypertension; systemic sclerosis; nailfold capillaroscopy; meta-analysis
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MDPI and ACS Style

Minopoulou, I.; Theodorakopoulou, M.; Boutou, A.; Arvanitaki, A.; Pitsiou, G.; Doumas, M.; Sarafidis, P.; Dimitroulas, T. Nailfold Capillaroscopy in Systemic Sclerosis Patients with and without Pulmonary Arterial Hypertension: A Systematic Review and Meta-Analysis. J. Clin. Med. 2021, 10, 1528. https://doi.org/10.3390/jcm10071528

AMA Style

Minopoulou I, Theodorakopoulou M, Boutou A, Arvanitaki A, Pitsiou G, Doumas M, Sarafidis P, Dimitroulas T. Nailfold Capillaroscopy in Systemic Sclerosis Patients with and without Pulmonary Arterial Hypertension: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2021; 10(7):1528. https://doi.org/10.3390/jcm10071528

Chicago/Turabian Style

Minopoulou, Ioanna, Marieta Theodorakopoulou, Afroditi Boutou, Alexandra Arvanitaki, Georgia Pitsiou, Michael Doumas, Pantelis Sarafidis, and Theodoros Dimitroulas. 2021. "Nailfold Capillaroscopy in Systemic Sclerosis Patients with and without Pulmonary Arterial Hypertension: A Systematic Review and Meta-Analysis" Journal of Clinical Medicine 10, no. 7: 1528. https://doi.org/10.3390/jcm10071528

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