A comparison of Doppler waveform parameters versus flow-mediated vascular dilation of the brachial artery in pregnant women
Objective Flow mediated dilation of the brachial artery is impaired with endothelial dysfunction. We previously identified that brachial artery waveforms were changed in preeclamptic women. We therefore sought to compare Doppler waveform analysis with flow mediated vascular dilation (FMVD) measurements in pregnant women. Study design A cross sectional study of 71 pregnant women at >20 weeks gestation comparing FMVD measurements with Doppler waveform parameters was performed. Research was conducted at three hospitals and two geographic settings; (1) Yale-New Haven Hospital in New Haven, CT, (2) Mount Hope Maternity and (3) Port of Spain General Hospital in Trinidad. Brachial artery Doppler waveform measurements were done at baseline and 90 s post cuff-release. From the Doppler waveforms we assessed percent change in Peak Systolic Velocity (% ΔPSV), systolic acceleration, acceleration time and pulsatility index and compared them with the percent change in FMVD. Statistical analysis using Student's t tests and correlation coefficient was done as necessary. Results Correlation analysis between the % change in the Doppler waveform parameters and the % change in mean FMVD identified only the waveform parameter of % ΔPSV as significantly correlated (p = 0.040). Conclusion FMVD remains the gold standard for assessment of endothelial dysfunction. A correlation was observed between the Doppler measured % ΔPSV and FMVD, which may allow it to be used to assess endothelial dysfunction changes under different conditions was identified. © 2014 International Society for the Study of Hypertension in Pregnancy Published by Elsevier B.V. All rights reserved.
Landres, IV; Small, M; Sirjusingh, A; Ramsewak, S; Williams, KP
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