Skip to main content

Abstract

Capillaroscopy or intravital videomicroscopy is a noninvasive imaging technique that is used for in vivo assessment of the microcirculation providing a 2-D projection of a 3-D capillary network. It generates high-contrast images, videotapes, or photographs of skin capillaries by means of television, video, and/or informatic systems. It allows the assessment of capillary morphology and capillary density (traditional capillaroscopy), capillary flow velocity (dynamic capillaroscopy), and capillary red cell column width. It can also be employed in combination with sophisticated methods in order to measure red blood cell velocity, capillary pressure (i.e., cannulated capillaries using micropipettes and micropressure devices), and transcapillary diffusion (capillary permeability) in combination with intravenous administration of fluorescent dyes, such as sodium fluorescein or indocyanine green (fluorescence videomicroscopy or fluorescence angiography), in order to evaluate the heterogeneity of capillary flow distribution or to disclose structures that cannot be seen with traditional capillaroscopy (such as capillary aneurisms), thus allowing comprehensive physiological and pharmacological studies in humans.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bollinger A, Fagrell B, editors. Clinical capillaroscopy: a guide to its use in clinical research and practice. Stuttgart: Hofgrefe & Huber Publishers; 1990.

    Google Scholar 

  2. Shore AC. Capillaroscopy and the measurement of capillary pressure. Br J Clin Pharmacol. 2000;50:501–13.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. Morris SJ, Shore AC, Tooke JE. Responses of the skin microcirculation to acetylcholine and sodium nitroprusside in patients with NIDDM. Diabetologia. 1995;38:1337–44.

    Article  CAS  PubMed  Google Scholar 

  4. Allen J, Howell K. Microvascular imaging: techniques and opportunities for clinical physiological measurements. Physiol Meas. 2014;35:R91–141.

    Article  PubMed  Google Scholar 

  5. Cutolo M, Sulli A, Smith V. How to perform and interpret capillaroscopy. Best Pract Res Clin Rheumatol. 2013;27(2):237–48.

    Article  PubMed  Google Scholar 

  6. Ingegnoli F, Gualtierotti R, Lubatti C, Bertolazzi C, Gutierrez M, Boracchi P, Fornili M, De Angelis R. Nailfold capillary patterns in healthy subjects: a real issue in capillaroscopy. Microvasc Res. 2013;90:90–5.

    Article  PubMed  Google Scholar 

  7. Dolezalova P, Young SP, Bacon PA, Southwood TR. Nailfold capillary microscopy in healthy children and in childhood rheumatic diseases: a prospective single blind observational study. Ann Rheum Dis. 2003;62(5):444–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  8. Lambova SN, Müller-Ladner U. The specificity of capillaroscopic pattern in connective autoimmune diseases. A comparison with microvascular changes in diseases of social importance: arterial hypertension and diabetes mellitus. Mod Rheumatol. 2009;19(6):600–5.

    Article  PubMed  Google Scholar 

  9. Chen ZY, Silver RM, Ainsworth SK, Dobson RL, Rust P, Maricq HR. Association between fluorescent antinuclear antibodies, capillary patterns, and clinical features in scleroderma spectrum disorders. Am J Med. 1984;77(5):812–22.

    Article  CAS  PubMed  Google Scholar 

  10. Cutolo M, Sulli A, Smith V. Assessing microvascular changes in systemic sclerosis diagnosis and management. Nat Rev Rheumatol. 2010;6(10):578–87.

    Article  PubMed  Google Scholar 

  11. Jung P, Trautinger F. Capillaroscopy. Minireview. J German Soc Dermatol. 2013;–:731–6.

    Google Scholar 

  12. Lack A. Biomicroscopy of conjunctival vessels in hypertension. Am Heart J. 1949;38:654–64.

    Article  CAS  PubMed  Google Scholar 

  13. Williams SA, Boolell M, MacGregor GA, Smaje LH, Wasserman SM, Tooke JE. Capillary hypertension and abnormal pressure dynamics in patients with essential hypertension. Clin Sci. 1990;79:5–8.

    CAS  PubMed  Google Scholar 

  14. Harper RN, Moore MA, Marr MC, Watts LE, Hutchins PM. Arteriolar rarefaction in the conjunctiva of human essential hypertensives. Microvasc Res. 1978;16:369–72.

    Article  CAS  PubMed  Google Scholar 

  15. Antonios TFT, Singer DRJ, Markandu ND, Mortimer PS, MacGregor GA. Structural skin capillary rarefaction in essential hypertension. Hypertension. 1999;33:998–1001.

    Article  CAS  PubMed  Google Scholar 

  16. Gasser P, Buhler FR. Nailfold microcirculation in normotensive and essential hypertensive subjects, as assessed by video-microscopy. J Hypertens. 1992;10:83–6.

    Article  CAS  PubMed  Google Scholar 

  17. Draaijer P, de Leeuw PW, van Hooff JP, Leunissen KM. Nailfold capillary density in salt- sensitive and salt-resistant borderline hypertension. J Hypertens. 1993;11:1195–8.

    CAS  PubMed  Google Scholar 

  18. Prasad A, Dunnill GS, Mortimer PS, MacGregor GA. Capillary rarefaction in the forearm skin in essential hypertension. J Hypertens. 1995;13:265–8.

    CAS  PubMed  Google Scholar 

  19. Schiffrin EL. Reactivity of small blood vessels in hypertension: relation with structural changes. State of the art lecture. Hypertension. 1992;19(Suppl II):II1–9.

    CAS  PubMed  Google Scholar 

  20. Struijker-Boudier HA, Agabiti Rosei E, Bruneval P, Camici PG, Christ F, Henrion D, Lévy BI, Pries A, Vanoverschelde JL. Evaluation of the microcirculation in hypertension and cardiovascular disease. Eur Heart J. 2007;28:2834–40.

    Article  PubMed  Google Scholar 

  21. Antonios TF, Singer DR, Markandu ND, Mortimer PS, MacGregor GA. Rarefaction of skin capillaries in borderline essential hypertension suggests an early structural abnormality. Hypertension. 1999;34(4 Pt 1):655–8.

    Article  CAS  PubMed  Google Scholar 

  22. Antonios TF, Rattray FM, Singer DR, Markandu ND, Mortimer PS, MacGregor GA. Rarefaction of skin capillaries in normotensive offspring of individuals with essential hypertension. Heart. 2003;89(2):175–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  23. Noon JP, Walker BR, Webb DJ, Shore AC, Holton DW, Edwards HV, Watt GCM. Impaired microvascular dilatation and capillary rarefaction in young adults with a predisposition to high blood pressure. J Clin Invest. 1997;99:1873–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  24. Humar R, Zimmerli L, Battegay E. Angiogenesis and hypertension: an update. J Hum Hypertens. 2009;23:773–82.

    Article  CAS  PubMed  Google Scholar 

  25. Greene AS, Tonellato PJ, Lui J, Lombard JH, Cowley Jr AW. Microvascular rarefaction and tissue vascular resistance in hypertension. Am J Physiol. 1989;256:H126–31.

    CAS  PubMed  Google Scholar 

  26. Levy BI, Schiffrin EL, Mourad JJ, Agostini D, Vicaut E, Safar ME, Struijker-Boudier HA. Impaired tissue perfusion: a pathology common to hypertension, obesity, and diabetes mellitus. Circulation. 2008;118:968–76.

    Article  PubMed  Google Scholar 

  27. Clark MG, Colquhoun EQ, Rattigan S, Dora KA, Eldershaw TP, Hall JL, Ye J. Vascular and endocrine control of muscle metabolism. Am J Physiol. 1995;268:E797–812.

    CAS  PubMed  Google Scholar 

  28. Serné EH, Gans ROB, Ter Maaten JC, Ter Wee PM, Donker AJM, Stehouwer CDA. Capillary recruitment is impaired in essential hypertension and relates to insulin’s metabolic and vascular actions. Cardiovasc Res. 2001;49:161–8.

    Article  PubMed  Google Scholar 

  29. Antonios TFT, Rattray FE, Singer DRJ, Markandu ND, Mortimer PS, MacGregor GA. Maximization of skin capillaries during intravital video-microscopy in essential hypertension: comparison between venous congestion, reactive hyperaemia and core heat load test. Clin Sci. 1999;97:523–8.

    Article  CAS  PubMed  Google Scholar 

  30. Schubert R, Mulvany MJ. The myogenic response: established facts and attractive hypotheses. Clin Sci. 1999;96:313–26.

    Article  CAS  PubMed  Google Scholar 

  31. Johnson PC, Burton KS, Henrich H, Henrich U. Effect of occlusion duration on reactive hyperemia in sartorius muscle capillaries. Am J Physiol. 1976;230:715–9.

    CAS  PubMed  Google Scholar 

  32. Serné EH, Stehouwer CDA, Ter Maaten JC, Ter Wee PM, Rauwerda JA, Donker AJM, Gans ROB. Microvascular function relates to insulin sensitivity and blood pressure in normal subjects. Circulation. 1999;99:896–902.

    Article  PubMed  Google Scholar 

  33. Serné EH, Gans RO, ter Maaten JC, Tangelder GJ, Donker AJ, Stehouwer CD. Impaired skin capillary recruitment in essential hypertension is caused by both functional and structural capillary rarefaction. Hypertension. 2001;38(2):238–42.

    Article  PubMed  Google Scholar 

  34. Antonios TF, Kaski JC, Hasan KM, Brown SJ, Singer DR. Rarefaction of skin capillaries in patients with anginal chest pain and normal coronary arteriograms. Eur Heart J. 2001;22(13):1144–8.

    Article  CAS  PubMed  Google Scholar 

  35. Pedrinelli R, Spessot M, Lorenzoni R, Marraccini P, L'Abbate A, Salvetti A, Camici P. Forearm vasodilatory capacity in patients with syndrome X: a comparison with normal and hypertensive subjects. J Hypertens Suppl. 1989;7(6):S92–3.

    Article  CAS  PubMed  Google Scholar 

  36. Sax FL, Cannon 3rd RO, Hanson C, Epstein SE. Impaired forearm vasodilator reserve in patients with microvascular angina. Evidence of a generalized disorder of vascular function? N Engl J Med. 1987;317(22):1366–70.

    Article  CAS  PubMed  Google Scholar 

  37. Buus NH, Bøttcher M, Bøttker HE, Sørensen KE, Nielsen TT, Mulvany MJ. Reduced vasodilator capacity in syndrome X related to structure and function of resistance arteries. Am J Cardiol. 1999;83(2):149–54.

    Article  CAS  PubMed  Google Scholar 

  38. Bøtker HE, Sonne HS, Sørensen KE. Frequency of systemic microvascular dysfunction in syndrome X and in variant angina. Am J Cardiol. 1996;78(2):182–6.

    Article  PubMed  Google Scholar 

  39. Francischetti EA, Tibirica E, da Silva EG, Rodrigues E, Celoria BM, de Abreu VG. Skin capillary density and microvascular reactivity in obese subjects with and without metabolic syndrome. Microvasc Res. 2011;81(3):325–30.

    Article  PubMed  Google Scholar 

  40. De Ciuceis C, Rossini C, Porteri E, La Boria E, Corbellini C, Mittempergher F, Di Betta E, Petroboni B, Sarkar A, Agabiti-Rosei C, Casella C, Nascimbeni R, Rezzani R, Rodella LF, Bonomini F, Agabiti-Rosei E, Rizzoni D. Circulating endothelial progenitor cells, microvascular density and fibrosis in obesity before and after bariatric surgery. Blood Press. 2013;22:165–72.

    Article  PubMed  Google Scholar 

  41. Paiardi S, Rodella LF, De Ciuceis C, Porteri E, Boari GEM, Rezzani R, Rizzardi N, Plato C, Tiberio GAM, Giulini SM, Rizzoni D, Agabiti Rosei E. Immunohistochemical evaluation of microvascular rarefaction in hypertensive humans and in spontaneously hypertensive rats. Clin Hemorheol Microcirc. 2009;42:259–68.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Enrico Agabiti Rosei .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Rosei, E.A., De Ciuceis, C., Rizzoni, D. (2015). Capillaroscopy. In: Agabiti Rosei, E., Mancia, G. (eds) Assessment of Preclinical Organ Damage in Hypertension. Springer, Cham. https://doi.org/10.1007/978-3-319-15603-3_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-15603-3_12

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-15602-6

  • Online ISBN: 978-3-319-15603-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics