scholarly journals PLASMA ATHEROGENIC INDEX IS AN INDEPENDENT INDICATOR AND PROGNOSTIC VALUE IN RAYNAUD’S PHENOMENON?

2019 ◽  
Vol 3 (12) ◽  
Author(s):  
Saadet Kader ◽  
Hakan Comaklı
Keyword(s):  
Biochemical Parameters ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
High Density ◽  
Atherogenic Index ◽  
Clinical Value ◽  
Cholesterol Ratio ◽  
Increased Risk ◽  
Significant Difference ◽  
High Density Cholesterol

Objective: Raynaud’s phenomenon (RP)  is characterized by cold induced temporary ischaemia of the fingers or toes  and an inflammatory autoimmune disease of connective tissues.  Plasma atherogenic index (PAI) is a valuable marker for the cardiovascular disease and cardiac risk. The aim of this study was to evaluate the role and clinical use of PAI in RP patients. Materials and Methods: In this retrospective-cohort study, we examined the clinical value count blood cells in 55 patients with RP and 14 clinical controls admitted Konya Training and Research Hospital Department of Cardiovascular Surgery between January 2016-March 2019 were investigated retrospectively screened.  PAI was measured as a logarithmic value of triglyceride to high-density cholesterol ratio. PAI levels <0.11 is accepted as low risk, 0,11-0,21 intermediate risk, and 0.21 >increased risk. PAI was measured as a logarithmic value of triglyceride to high-density cholesterol ratio. The lipid and other biochemical parameters of patient and control groups were examined and measured. Results: The study consisted of 29 females (42.03%) and 40 males (57.97%). There was a significant difference between differences between PAI level groups. There was no significant difference in PAI results between genders (p>0.355).We also found disagreement in biochemical parameters and PAI between controls and patients. Conclusion: When we evaluated PAI in the patients with RP and controls, it was determined that there was no significant difference in either parameter. However, PAI levels have showed that significant elevated between groups so It can be a simple, economic and non invasive marker to identify for future studies. Keywords: Raynaud’s phenomenon, Plasma atherogenic index, Blood lipid components

Impaired transient vasodilation and increased vasoconstriction to digital local cooling in primary Raynaud's phenomenon

2011 ◽  
Vol 301 (2) ◽  
pp. H324-H330 ◽  
Author(s):  
Matthieu Roustit ◽  
Sophie Blaise ◽  
Claire Millet ◽  
Jean-Luc Cracowski
Keyword(s):  
Blood Flow ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Topical Anesthesia ◽  
Sensory Nerves ◽  
Local Cooling ◽  
Doppler Flowmetry ◽  
Percentage Decrease ◽  
Significant Difference ◽  
And Gender

Raynaud's phenomenon (RP) is defined as episodic ischemia of the extremities in response to cold. Although the structure of skin capillaries is normal in primary RP, some data suggest impairment of microvascular function. We aimed at testing whether digital skin blood flow was lower in RP than in controls while cooling locally. We further evaluated the contribution of sensory nerves in the response. We recruited 21 patients with primary RP and 20 healthy volunteers matched on age and gender. After a 10-min baseline at 33°C, skin temperature was cooled at 15 or 24°C during 30 min on the forearm and the finger while monitoring perfusion with a custom-design laser Doppler flowmetry probe. Perfusion was also assessed after topical anesthesia. Blood flow was expressed as cutaneous vascular conductance (CVC). Data were subsequently expressed as area above the curve (AAC0–30) of the percentage decrease from baseline CVC (%BL). CVC on the dorsum of the finger was lower in RP patients compared with controls at 15°C (AAC0–30 were 106,237.2 and 69,544.3%BL·s, respectively; P = 0.02) and at 24°C (AAC0–30 were 86,915 and 57,598%BL·s, respectively; P = 0.04) whereas we observed no significant difference on the finger pad and the forearm. Topical anesthesia increased CVC in patients with RP ( P = 0.05), whereas it did not affect reactivity in controls ( P = 0.86). Our study shows exaggerated skin microvascular vasoconstriction to local cooling on the dorsum of the finger in primary RP compared with controls. Part of this abnormal response in primary RP depends on sensitive nerves.

Clinical Significance of Cryofibrinogenemia: Possible Pathophysiological Link with Raynaud’s Phenomenon

2011 ◽  
Vol 39 (1) ◽  
pp. 119-124 ◽  
Author(s):  
MUHAMMAD S. SOYFOO ◽  
AHMED GOUBELLA ◽  
ELIE COGAN ◽  
JEAN-CLAUDE WAUTRECHT ◽  
ANNICK OCMANT ◽  
...  
Keyword(s):  
Raynaud’S Phenomenon ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Raynaud's Phenomenon ◽  
Clinical Findings ◽  
University Hospital ◽  
Significant Difference ◽  
Primary Raynaud’S Phenomenon ◽  
The Mean ◽  
Mean Concentration

Objective.To describe the clinical findings and prevalence of patients with cryofibrinogenemia (CF) and to determine whether CF is associated with primary Raynaud’s phenomenon.Methods.Between June 2006 and December 2009, 227 patients were tested for CF in a single university hospital. Forty-five patients with primary Raynaud’s phenomenon were tested for CF.Results.A total of 117 patients with CF without cryoglobulinemia were included. The main clinical manifestations included skin manifestations (50%) and arthralgia (35%). There were 67 patients with primary CF and 50 patients with secondary CF. There was no significant difference in the mean concentration of the cryoprecipitate in primary CF as compared to the secondary form (172 ± 18.6 vs 192 ± 20.9 mg/dl, respectively; p = 0.41). Highest concentrations of cryoprecipitate were observed in those containing fibrinogen only as compared to cryoprecipitates containing fibrinogen and fibronectin (301 ± 43.5 vs 125 ± 10.6 mg/dl; p < 0.001). Patients having skin necrosis (n = 3) had significantly higher values of cryofibrinogen compared to those without necrosis (638 ± 105 vs 160 ± 10.2 mg/dl; p = 0.0046). Among the 45 patients with primary Raynaud’s phenomenon, 36 had associated CF. There was no significant difference in the mean concentration of the cryoprecipitate in these patients compared to those with primary CF.Conclusion.There seems to be a significant correlation between cryofibrinogen concentration and the severity of the clinical signs, particularly when cryoprecipitate is composed of fibrinogen alone. CF might have a possible pathophysiological role in primary Raynaud’s phenomenon.

scholarly journals Investigation of autonomic dysfunction in primary Raynaud’s phenomenon with sympathetic skin response (SSR), R-R interval variation (RRIV) and composite autonomic symptom score (COMPASS)-31

2021 ◽  
Vol 26 (4) ◽  
pp. 693-698
Author(s):  
Hüseyin Sicim ◽  
Özgür Boyraz ◽  
Ertan Demirdas ◽  
Hakan Kartal ◽  
Gökhan Erol ◽  
...  
Keyword(s):  
Autonomic Dysfunction ◽  
Valsalva Maneuver ◽  
Raynaud’S Phenomenon ◽  
Sympathetic Skin Response ◽  
Raynaud's Phenomenon ◽  
Deep Breathing ◽  
Control Groups ◽  
Significant Difference ◽  
Skin Response ◽  
And Control

Background: In this study, we aimed to investigate the autonomic dysfunction in patients with primary Raynaud’s phenomenon with using sympathetic skin response (SSR) as a neurophysiologic test, R-R interval variation analysis and composite autonomic symptom score (COMPASS)-31 questionnaire. Methods: Palmar SSR to median nerve electrical stimulation was recorded in 38 patients with 36 healthy age and sex-matched control subjects. The SSR was recorded from the palmar surface of both left and right hands for patients and control groups. The amplitudes and latencies formed as a result of electrical stimulation were calculated and compared between the two groups. Additionally, R-R interval variability was examined during normal breathing, deep breathing, standing up and Valsalva maneuver in both groups. Furthermore, we asked to complete the COMPASS-31 questionnaire, a validated tool to assess symptoms of autonomic dysfunction. And by calculating total COMPASS-31 scores, the relationship between the two groups was investigated. Results: The Raynaud’s phenomenon and control groups were similar in age (37.4 ± 11.6 vs. 34.9 ± 13.0 years), had identical gender ratios and similar body mass index (24.5 ± 6.1 vs. 25.7 ± 4.6%). Palmar SSR to median nerve stimulation of RP patients shows significantly delayed latency (1890 ± 146) (p=0.03). And no difference between amplitudes in comparison to the control group. In the patient and control groups, R-R interval measurements were evaluated during rest and deep breathing, standing up and Valsalva maneuver. When the R-R interval measurements of the patient and control groups at rest and deep breathing were compared, there was no statistically significant difference between the groups. In addition, COMPASS-31 questionnaire scoring system was applied to both groups. The mean COMPASS-31 score was higher in patient group (22.8 ± 13.8), than from healthy controls (8.9 ± 7.8) (p=0.02) Conclusions: Autonomic dysfunction plays a role in the etiology of Raynaud’s phenomenon, due to latency prolongation in the sympathetic skin response and significant difference between COMPASS-31 tests, and these tests can be used in the diagnosis stage of this disease.

scholarly journals AB0582 DIAGNOSING SYSTEMIC SCLEROSIS WITH PHOTOACOUSTIC AND HIGH-FREQUENCY ULTRASOUND IMAGING

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1588.1-1588
Author(s):  
B. Kersten ◽  
K. Daoudi ◽  
C. H. M. Van den Ende ◽  
F. Van den Hoogen ◽  
C. De Korte ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Early Diagnosis ◽  
Oxygen Saturation ◽  
High Frequency ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Skin Thickness ◽  
High Frequency Ultrasound ◽  
Significant Difference ◽  
Frequency Ultrasound

Background:Vasculopathy is already evident in early systemic sclerosis (SSc); Raynaud’s phenomenon and typical nailfoldcapillaroscopic findings are part of the criteria of very early diagnosis of SSc (VEDOSs) (1). As not all early SSc patients have alterations in their nailfoldcapillaries, there is need for other diagnostic tools. Photoacoustics(PA) and high-frequency ultrasound (HFUS) might be able to fulfill this need (2). The former can measure the oxygen saturation of hemoglobin by using short pulsed laser light while the latter can provide high-resolution images that allow measuring skin thickening distal from DIP joint, which could be used to determine skin involvement early.Objectives:We hypothesize that photoacoustics and high-frequency ultrasound can distinguish (early) SSc patients from individuals with primary Raynaud’s phenomenon (PR) by measuring the oxygenation (by PA) of the fingertip and skin thickening (by HFUS).Methods:In our cross-sectional study, we compared measurements of the third finger in (early)SSc patients with individuals with PR and healthy volunteers. Smoking and beta-blockage were exclusion criteria. The level of oxygenation (by PA) and skin thickness (by HFUS) were compared between groups. Nailfoldcapillaroscopy was performed on all subjects and analyzed for the pattern.Results:Thirty-one adult subjects participated in this study: twelve patients with SSc, 5 patients with early SSc, 5 volunteers with PR and 9 healthy controls.We found a significant difference in median (IQR) oxygen saturation between earlySSc patients 75.9% (IQR 75.1%-86.6%) and subjects with PR 94.1% (IQR 93.1%-94.5%) (p=0.0002) using the Wilcoxon rank-sum test (figure 1).Figure 1.Boxplot of saturation (%) per group.Measurements of skin thickening also showed a significant difference in early SSc patients compared to subjects with PR, respectively 0.5mm (IQR 0.4mm-0.5mm) vs. 0.3mm (IQR 0.3mm-0.3mm), P=0.0002 (figure 2).Figure 2.Boxplot of skin thickness (mm) per group.Conclusion:Our results demonstrate that photoacoustic and high-frequency ultrasound can distinguish between (early)SSc and PR in both oxygenation saturation and skin thickening. In a larger prognostic study we want to determine the value of photoacoustic and high frequency ultrasound in diagnosing earlySSc.References:[1]Minier T, Guiducci S, Bellando-Randone S, Bruni C, Lepri G, Czirjak L, et al. Preliminary analysis of the very early diagnosis of systemic sclerosis (VEDOSS) EUSTAR multicentre study: evidence for puffy fingers as a pivotal sign for suspicion of systemic sclerosis. Annals of the rheumatic diseases. 2014;73(12):2087-93.[2]Wang LV, Yao J. A practical guide to photoacoustic tomography in the life sciences. Nature methods. 2016;13(8):627-38Disclosure of Interests:Brigit Kersten: None declared, Khalid Daoudi: None declared, C.H.M. van den Ende: None declared, FHJ van den Hoogen Consultant of: AbbVie, Actelion, Biogen, BMS, Celltrion, Corbus, Eli-Lilly, Mundipharma, Pfizer, Sanofi-Genzyme, Speakers bureau: Amgen, Boehringer-Ingelheim, Novartis, CL de Korte: None declared, Madelon Vonk Grant/research support from: Janssen and Ferrer, Consultant of: Boehringer Ingelheim, Janssen and GSK, Speakers bureau: Boehringer Ingelheim, BMS and Roche

scholarly journals Photoacoustic and high-frequency ultrasound imaging of systemic sclerosis patients

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Khalid Daoudi ◽  
Brigit E. Kersten ◽  
Cornelia H. M. van den Ende ◽  
Frank H. J. van den Hoogen ◽  
Madelon C. Vonk ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Oxygen Saturation ◽  
High Frequency ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Skin Thickness ◽  
Healthy Controls ◽  
High Frequency Ultrasound ◽  
Significant Difference ◽  
Frequency Ultrasound

Abstract Introduction Systemic sclerosis starts with an early phase characterized by Raynaud’s phenomenon, puffy fingers/hands, autoantibodies, and a scleroderma nailfold microscopic pattern. Alterations in the nailfold microscopic pattern are not evident in all early SSc patients. Photoacoustics (PA) and high-frequency ultrasound (HFUS) could fulfill this need. The former can measure oxygen saturation while the latter can measure skin thickening. We hypothesize that photoacoustics and high-frequency ultrasound can distinguish (early) SSc patients from individuals with primary Raynaud’s phenomenon (PRP) by measuring oxygenation of the fingertip and skin thickening. Methods We compared measurements of oxygenation and skin thickness of the third finger between (early) SSc patients and PRP individuals and healthy controls. The spearman rank correlation was used to analyze an association between capillary density and oxygen saturation of the fingers. Results Thirty-one adult subjects participated in this study: twelve patients with SSc, 5 patients with early SSc, 5 volunteers with PR, and 9 healthy controls. We found a significant difference in oxygen saturation between (early) SSc patients (80.8% ± 8.1 and 77.9% ± 10.5) and individuals with PRP (93.9% ± 1.1). Measurements of skin thickening showed a significant difference in (early) SSc patients compared to individuals with PRP (0.48 ± 0.06 mm and 0.51 ± 0.16 mm vs. 0.27 ± 0.01 mm). There was no significant difference between healthy and PRP individuals in oxygenation or skin thickening. Conclusion Photoacoustic and high-frequency ultrasound could help to distinguish between (early) SSc, PRP, and healthy individuals in both oxygenation and skin thickening.

scholarly journals Implantable loop recorders in patients with a structural or electrical heart disease: comparison of the clinical value in patients with and without a history of syncope

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
A Assaf ◽  
R Sakhi ◽  
M Michels ◽  
JW Roos-Hesselink ◽  
JMA Verhagen ◽  
...  
Keyword(s):  
Heart Disease ◽  
Primary Endpoint ◽  
Clinical Value ◽  
Loop Recorder ◽  
Increased Risk ◽  
Significant Difference ◽  
Electrical Heart Disease ◽  
History Of ◽  
Group A ◽  
Group B

Abstract Funding Acknowledgements Type of funding sources: None. Background Patients with structural and electrical heart disease are at increased risk for sudden cardiac death. Guidelines recommend the use of an implantable loop recorder (ILR) in symptomatic patients when symptoms are sporadic and suspected to be related to arrhythmias. In clinical practice, an ILR is mainly used in patients with unexplained syncope. Purpose To compare the clinical value of an ILR in patients with a heart disease and a history of syncope versus those with non-syncopal suspected arrhythmia-related symptoms. Methods In this observational single-center study we included symptomatic patients with structural or electrical heart disease who received an ILR. The primary endpoint was an actionable event which was defined as an arrhythmic event leading to a change in clinical management. The secondary endpoint was an event leading to implantation of a pacemaker or implantable cardioverter-defibrillator (ICD). Results A total of 120 patients (mean age 47 ± 17 years, 49% men) were included. Underlying disease substrate was inherited cardiomyopathy (31%), congenital heart disease (28%), channelopathy (23%), and other structural heart disease (18%).There were 43 patients with a history of syncope (group A) and 77 patients with non-syncopal symptoms (group B) such as palpitations, dizziness and/or near-syncope at baseline. During a median follow-up of 19 months (IQR 8-36), a primary endpoint was reached in 14 patients (33%) of group A, and in 28 patients (36%) of group B (logrank P = 0.54, Figure A). There was also no significant difference in the cumulative rate of cardiac device implantation between group A and B, 14% versus 10%, respectively (logrank P = 0.97, Figure B). Conclusion Our results show no differences in ILR yield in patients with structural or electrical heart disease who present with any suspected arrhythmia-related symptom, including those with non-syncopal symptoms. Abstract Figure.

scholarly journals Myositis in systemic lupus erythematosus

Lupus ◽  
2021 ◽  
pp. 096120332098858
Author(s):  
Thaisa Cotton ◽  
Omid Zahedi Niaki ◽  
Boyang Zheng ◽  
Christian A Pineau ◽  
Marvin Fritzler ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Cox Regression ◽  
Raynaud’S Phenomenon ◽  
Damage Index ◽  
Group Versus ◽  
Raynaud's Phenomenon ◽  
Increased Risk ◽  
History Of ◽  
Race Ethnicity ◽  
Low Incidence

Objectives Myositis is an infrequent feature of SLE and may often be overlooked. We aimed to estimate the incidence of myositis in SLE, and to determine demographic and clinical factors associated with it. Methods Within our lupus cohort, we identified potential myositis cases using the SLICC Damage Index for muscle atrophy or weakness, the SLEDAI-2K item for myositis, and annually measured serum creatinine kinase. Cases were confirmed through chart review. We performed descriptive analyses of prevalent myositis cases as of January 2000. From that point onward, we studies patients without myositis to determine risk of incident myositis, using cohort analyses adjusted for demographic variables (age, sex, race/ethnicity). Results As of January 2000, there were 5 prevalent myositis cases in our SLE cohort. Among 560 SLE patients with a study visit from January 2000 onward, with no history of myositis at baseline, 5 new cases (4 females, 1 male) were identified over an average follow-up of 8.5 years (incidence 1.05 cases per 1000 person-years). There was a higher proportion of Caucasians in the non-myositis group versus myositis group, with a trend for fewer females in the myositis cases. Arthritis, Raynaud’s phenomenon, and anti-Smith antibodies were common pre-existing features, occurring in all incident myositis cases. In Cox regression analyses adjusting for age, race/ethnicity and sex, non-Caucasian patients had a markedly increased risk of developing myositis. Conclusion We found a low incidence of myositis in our SLE cohort. A cluster of variables, particularly non-Caucasian race/ethnicity, arthritis, Raynaud’s phenomenon, and anti-Smith antibodies were associated with risk of developing myositis in SLE. These variables may aid clinicians in identifying SLE patients at highest risk for this important complication.

Non-Invasive Investigation of Endothelium-Dependent Dilatation of the Brachial Artery in Women with Primary Raynaud's Phenomenon

1998 ◽  
Vol 94 (3) ◽  
pp. 239-243 ◽  
Author(s):  
Åsa Ringqvist ◽  
Tommy Jonason ◽  
Jerzy Leppert ◽  
Ivar Ringqvist
Keyword(s):  
Brachial Artery ◽  
Room Temperature ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Whole Body ◽  
Significant Difference ◽  
Flow Mediated Dilatation ◽  
Primary Raynaud’S Phenomenon ◽  
Body Cooling ◽  
Whole Body Cooling

1. Primary Raynaud's phenomenon is characterized by white fingers and toes with impaired perfusion in response to cold or emotional stress. The aetiology has not been clarified. In previous studies we have demonstrated a season-linked inability in women with primary Raynaud's phenomenon to raise their plasma cGMP levels in response to whole-body cooling, suggesting a dysfunction of the l-arginine—NO—cGMP pathway. To further elucidate the possibility of such a defect in patients with primary Raynaud's phenomenon, we determined flow-mediated dilatation of the brachial artery. 2. Twenty-two premenopausal, non-smoking women with primary Raynaud's phenomenon (mean age 39 ± 8 years) and 23 healthy controls (mean age 41 ± 7 years) were studied during two winter weeks. The diameter of the right arm brachial artery was measured by high resolution ultrasonography, at rest and during reactive hyperaemia. The investigation was conducted both with the participants at rest at room temperature and after 40 min of whole-body cooling. 3. Both study groups showed a marked attenuation of flow-mediated dilatation during whole-body cooling, which could partly but not solely be explained by a decreased shear rate. There was, however, no significant difference in flow-mediated diameter (D) increase (% flow-mediated dilatation; ΔD/D × 100) between primary Raynaud's phenomenon and controls, either at room temperature (7.8 ± 0.8 and 9.0 ± 0.8) or in response to whole-body cooling (3.8 ± 1.2 and 4.4 ± 0.7). 4. Thus, whole-body cooling markedly impairs flow-mediated dilatation in women. Flow-mediated dilatation is, however, not decreased in women with primary Raynaud's phenomenon at room temperature or during whole-body cooling, indicating that this particular aspect of endothelial function is not impaired in this setting.

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