SKIN MANIFESTATIONS OF SYSTEMIC ATHEROSCLEROSIS: DERMATOGLYPHIC AND MICROCIRCULATORY CORRELATES OF CORONARY HEART DISEASE

Abstract

Coronary heart disease (CHD) remains one of the leading causes of cardiovascular mortality, despite improvements in diagnostic and treatment methods. Current clinical guidelines emphasize the need for early risk stratification and a personalized approach to the prevention of atherosclerotic complications. In this regard, noninvasive markers that can reflect the systemic nature of endothelial dysfunction and complement traditional risk scales are of particular interest (SCORE, Framingham).

The aim of the work is to substantiate the clinical significance of dermatoglyphic and microcirculatory parameters of the skin as additional tools for assessing cardiovascular risk in patients with coronary heart disease.

In the process of preparing the paper, a critical analysis of the literature indexed in international databases was carried out, with an emphasis on the pathophysiological mechanisms of the relationship between systemic atherosclerosis and skin manifestations. The data on the synchronicity of embryogenesis of the cardiovascular system and papillary patterns, as well as on the role of endothelial dysfunction in the formation of microcirculatory skin disorders, are considered. It has been established that dermatoglyphic signs (decreased crest count, changes in the angle of ATD, asymmetry of patterns) can serve as markers of an individual predisposition to coronary heart disease due to disorders of early ontogenesis. Microcirculation parameters (capillary density, vasomotor reactivity), assessed by capillaroscopy and laser Doppler flowmetry, correlate with the severity of coronary atherosclerosis and the functional class of angina pectoris.

It was determined that skin markers have additional predictive potential in cardiology practice and can be integrated into risk stratification algorithms, especially in patients with borderline values of traditional scales. The introduction of noninvasive assessment of dermatoglyphics and microcirculation requires standardization of methods and interdisciplinary interaction between cardiologists and dermatologists. A promising area is the development of integral risk indices and the use of digital technologies for automated analysis of skin parameters in order to identify people with high cardiovascular risk early.