Association between Nailfold Capillaroscopy, Tobacco and Chronic Pulmonary Emphysema Cross-Sectional Study.

Abstract

Vascular damage related to smoking causes more deaths than lung cancer. There are minimally invasive techniques, such as nailfold capillaroscopy, that allow the study of these vascular alterations in diverse pathologies.

The main objective in this observational cross-sectional study was to evaluate the association between smoking, pulmonary emphysema and microvascular damage evidenced through nailfold capillaroscopy. Thirty patients from the pulmonology clinic of the Centro Médico Docente la Trinidad were included, seven active smokers, seventeen ex-smokers and six non-smokers, who had undergone complementary studies such as hemoglobin, spirometry, carbon monoxide diffusion and high-resolution computed tomography of the thorax. They were subsequently contacted via telephone to perform, in a blinded manner, the capillaroscopy, which was analyzed by two independent observers.

The results showed that smokers, both current and ex-smokers, presented a higher proportion of capillaroscopic alterations, such as capillary dilations and mega capillaries (p: 0.01; 0.002; respectively), with no association with the presence of pulmonary emphysema, or with decreased carbon monoxide diffusion. The agreement between both observers in nailfold capillaroscopy was moderate (Cohen's Kappa: 0.59).

In conclusion, the study shows the relationship between abnormal findings in capillaroscopy and tobacco, regardless of the diagnosis of pulmonary emphysema and abnormal findings in pulmonary function tests, suggesting the potential vascular effect of smoking, independent of lung damage.