Capillary morphology of finger nailfold capillaries in patients with arterial occlusive disease of the lower limbs

Background Changes of hemorheology in patients with peripheral arterial occ lusive disease (PAOD) like the increase of the plasmaviscosity, the aggrega tion of erythrocytes and the level of fibrinogen have a higher importance i n coherence with the endothelial dysfunction. The hands of patients sufferi ng from PAOD on the leg should be examinated by nailfold capillaroscopy, wi th regardto changes of microcirculation also in vessels not affected by art eriosclerosis. Patients and methods: The nailfold capillarys on finger II-V of each hand were investigated by capillaroscopy in 27 patients suffering from PAOD on the leg and 12 probands with healthy vessels. The findings wer e evaluated and compared digitally by visual display unit, Results: The mean values of the diameters of the arteriolar (8.5 +/- 1.3 pm vs. 7.6 +/- 0.9 mum; p < 0.05) and venular limbs of the capillary loops (1 0.8 +/- 1.2 pm vs. 9.3 +/- 1.0 mum; p < 0.001), as well as the width of cre st (14.1 +/- 2.3 pm vs. 11.5 +/- 0.9 pm; p < 0,001), showed that these were significantly higher in patients with PAOD than in healthy controls. Capil lary density, capillary width and visible length of capillaries were not ch anged significantly. The vasculary risk factors arterial hypertension and diabetes mellitus dist ributed equally in both groups did not influence the results, but venular d iameter and capillary width were influenced by the smoking habit, distribut ed equally too, Conclusions: The enlargements of the finger capillary loops in patients suf fering from PAOD on the leg ran be interpreted as functional disturbances o f the systemic vasomotorics on the basis of endothelial dysfunction and imp aired hemorheology. Our results show that the capillaroscopy can be a usefu l method to assess the cardiovascular risk of a patient and to objectify ea rly functional changes of microcirculation in PAOD.