Prolonged Capillary Refill Time Highlights Early Performing of Nailfold Capillaroscopy in Patients with Systemic Sclerosis

English (OpenAlex)

Objective: Systemic sclerosis (SSc) is a progressive connective tissue disorder that features vascular injury and persistent fibrosis with an autoimmune background. The hypoxic state at the capillary caused by SSc can be assessed with several methods. This study thus investigated the capillary refill time (CRT) effectivity in evaluating peripheral circulation in SSc patients. Method: This prospective, case-control study was conducted with SSc patients and gender and age-matched healthy controls. The CRT measurements were performed by a rheumatologist unaware of patients' records with a smartphone camera in the optimized test ambiance. A video processing software was then applied for the captured videos. Result: 61 patients with SSc and 60 controls participated in this study. According to disease involvement, the patients were then divided into diffuse cutaneous SSc (dSSc) and limited cutaneous SSc. Mainly, CRT was prolonged in the patient group than in the control group. CRT was also prolonged in patients with pathological capillaroscopy patterns in the nail fold capillaroscopy (NFC), below 50 years old, or whose disease duration was over three years. Per disease involvement, patients in the dSSc group with pathologic NFC had prolonged CRT results and higher pulmonary artery pressure levels. The use of CRT for NFC positivity in patients with SSc was practicable (AUC: 0.717;95% CI 0.714-0.942; 83.95% accuracy; 67.9% sensitivity, 100% specificity, 100% positive predictive value, 21.7% negative predictive value, P=0.015) Conclusion: CRT is markedly prolonged in patients with SSc. Evaluating CRT with the NFC positivity may provide pulmonary progression predictable, notably in dSSc patients.