TY - JOUR T1 - Is nailfold videocapillaroscopy a valuable diagnostic tool in pulmonary hypertension? JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P972 AU - Florian Meier AU - Matthias Geyer AU - Henning Tiede AU - Andreas Rieth AU - Hossein Ardeschir Ghofrani AU - Ulf Müller-Ladner AU - Robert Dinser AU - Walter Hermann Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P972.abstract N2 - Background: Pulmonary hypertension (PH) can be based on idiopathic pulmonary arterial hypertension (iPAH), connective tissue diseases such as systemic sclerosis (SSc-PAH), left heart disease (LHD-PH), chronic obstructive pulmonary disease (COPD-PH), or chronic thromboembolic events (CTEPH).Objectives: Analysis of microvascular patterns of patients with PH has been performed using nailfold videocapillaroscopy (NVC). The benefit of NVC in PH was evaluated with focus on SSc patients.Methods: NVC was performed in 81 patients. 2nd-5th fingers were bilaterally analyzed. Pictures were scored for capillary density (CD, capillaries/mm), and dimensions. Parameters such as hemorrhages and neoangiogenesis or capillary alterations such as ectasia (>20µm) and giant shape (>50µm) were qualitatively assessed.Results: 14.8% had iPAH, 14.8% LHD-PH, 7.4% COPD-PH and 17.2% CTEPH. 45.7% had SSc and 12.3% SSc-PAH. The CD in SSc-PAH was significantly lower compared to all other PH forms (4.9 vs. 10.2, 10.0, 11.7 and 9.47 in iPAH, LHD-PH, COPD-PH and CTEPH; p<0.0001), but did not differ compared to SSc non-PAH (4.7; p=0.73). In general, capillary dimensions were larger in SSc-PAH (p<0.0001). Ectasias were very common in SSc-PAH (90%), but to some extent present in other forms (e.g. COPD-PH 71.4%). Giant capillaries were only present in SSc (84.6% and 70%). Hemorrhages occurred in all disease forms of this study, mostly in COPD-PH (85.7%) and SSc (80%).Conclusions: Assessing capillary density in PH is a powerful tool to discriminate between SSc-PAH and other forms of PH. In this respect, NVC should be considered, besides checking for antinuclear antibodies, if the underlying cause of PH is unclear to determine SSc-PAH. ER -