A comparison of Doppler waveform parameters versus flow-mediated vascular dilation of the brachial artery in pregnant women

Inna V Landres; Maria Small; Adesh Sirjusingh; Samuel Ramsewak; Keith P Williams

doi:10.1016/j.preghy.2014.04.005

A comparison of Doppler waveform parameters versus flow-mediated vascular dilation of the brachial artery in pregnant women

Pregnancy Hypertens. 2014 Jul;4(3):220-3. doi: 10.1016/j.preghy.2014.04.005. Epub 2014 May 3.

Authors

Inna V Landres¹, Maria Small², Adesh Sirjusingh³, Samuel Ramsewak³, Keith P Williams⁴

Affiliations

¹ Stony Brook Department of Obstetrics and Gynecology, 6 Technology Drive, Suite 200, East Setauket, NY 11733, United States.
² Department of Obstetrics and Gynecology, Duke University Medical Center, DUMC 3967, Durham, NC 27710, United States.
³ Department of Obstetrics and Gynecology, Mount Hope Maternity Hospital, University of the West Indies, Trinidad and Tobago.
⁴ Department of Obstetrics and Gynecology, Rowan University - School of Osteopathic Medicine, Stratford, NJ, United States. Electronic address: williakp@rowan.edu.

PMID: 26104609
DOI: 10.1016/j.preghy.2014.04.005

Abstract

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 >20weeks 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 90s 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.

Keywords: Brachial artery waveform; Doppler ultrasound; Endothelial dysfunction; Flow mediated vascular dilation.