Pulsatility Index Change of Brachial Artery Shows Better Reproducibility than Flow-Mediated Vasodilation

Lima, Jailson Costa; Martins, Wellington P.; Nastri, C.O.; Nicolau, Luis Guilherme; Filho, Francisco Mauad

doi:10.1016/j.ultrasmedbio.2010.09.005

Cited by 8 publications

(13 citation statements)

References 21 publications

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“…To determine the maternal vascular response, if any, to melatonin administration we undertook arterial Doppler indices from the right brachial and bilateral uterine arteries at each predelivery time point using a Philips iU22 ultrasound machine (Philips Medical Systems, Bothell, WA, USA). Brachial artery pulsatility index (PI) change (PIC) was obtained using a Philips linear 5.0‐17.0 MHz probe (L17‐5) using previously described methods . Subjects rested for at least 10 minutes and were positioned in supine position with slight abduction of the right arm.…”

Section: Methodsmentioning

confidence: 99%

Melatonin improves endothelial function in vitro and prolongs pregnancy in women with early‐onset preeclampsia

Hobson

Gurusinghe

Lim

et al. 2018

Journal of Pineal Research

116

111

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Preeclampsia remains a leading cause of maternal and perinatal morbidity and mortality. There have been no material advances in the treatment of preeclampsia for nearly 50 years. Combining in vitro studies and a clinical trial, we aimed to determine whether melatonin could be a useful adjuvant therapy. In a xanthine/xanthine oxidase (X/XO) placental explant model, melatonin reduced oxidative stress (8-isoprostane) and enhanced antioxidant markers (Nrf2 translocation, HO-1), but did not affect explant production of anti-angiogenic factors (sFlt, sEng, activin A). In cultured HUVECs, melatonin mitigated TNFα-induced vascular cell adhesion molecule expression and rescued the subsequent disruption to endothelial monolayer integrity but did not affect other markers for endothelial activation and dysfunction. In a phase I trial of melatonin in 20 women with preeclampsia, we assessed the safety and efficacy of melatonin on (i) preeclampsia progression, (ii) clinical outcomes, and (iii) oxidative stress, matching outcomes with recent historical controls receiving similar care. Melatonin therapy was safe for mothers and their fetuses. Compared to controls, melatonin administration extended the mean ± SEM diagnosis to delivery interval by 6 ± 2.3 days reduced the need for increasing antihypertensive medication on days 3-4 (13% vs 71%), days 6-7 (8% vs 51%), and at delivery (26% vs 75%). All other clinical and biochemical measures of disease severity were unaffected by melatonin. We have shown that melatonin has the potential to mitigate maternal endothelial pro-oxidant injury and could therefore provide effective adjuvant therapy to extend pregnancy duration to deliver improved clinical outcomes for women with severe preeclampsia.

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Section: Methodsmentioning

confidence: 99%

Melatonin improves endothelial function in vitro and prolongs pregnancy in women with early‐onset preeclampsia

Hobson

Gurusinghe

Lim

et al. 2018

Journal of Pineal Research

116

111

View full text Add to dashboard Cite

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“…and Lima et al . suggest that measurement errors as small as 0.05 mm can compromise the results . The error of measurement of calliper placement in our study was 0.04 mm.…”

Section: Discussionmentioning

confidence: 99%

“…PI especially provides an amplified response compared with the minimal response seen in FMD. PI and RI have been used in several clinical studies as an adjunct or a comparator to FMD with a goal of predicting risk of vascular systemic conditions in obstetrics . PIC was found to have a high correlation with age, body mass index, waist circumference, BP simplified Framingham score and intima–media thickness .…”

Section: Discussionmentioning

confidence: 99%

“…Flow‐mediated dilation has been adapted to suit several cardiovascular applications . However, it can be technically challenging with protocol, sonographer experience, operator dependency and intra‐individual variability . FMD response has been found to be widely variable between subjects because of several technical and physiological factors, which is a potential limiting factor for determining reference values and for clinical translation of FMD …”

Section: Introductionmentioning

confidence: 99%

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Reliability of sonographic measurements of endothelial function: Flow‐mediated dilation, blood flow velocity, resistive and pulsatility indices

et al. 2018

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Introduction Several established and emerging sonographic measurements of vascular health are used in clinical practice and research. The aim of this study was to compare inter‐rater and intra‐rater reliability of baseline, post‐cuff‐release and percentage change of brachial artery flow‐mediated dilation (FMD); flow velocity; resistive index (RI); and pulsatility index (PI). Methods Healthy, older (45–70 years), overweight (body mass index 27–32 kg/m2) adults were sonographically assessed for arterial diameter, flow velocity and Doppler indices before and after transient ischaemia. Repeat scans were performed by either one rater (n = 10) or two different raters (n = 6) to assess reliability with intra‐class correlation coefficients (ICCs). Results Intra‐class correlation coefficients for intra‐rater reliability were highest for baseline diameter (0.97) and post‐cuff‐release diameter (0.96) but lowest for FMD (0.04). For inter‐rater reliability, ICC for baseline diameter was high (0.93). ICCs for intra‐rater and inter‐rater reliability for percentage change in velocity, percentage change in RI and percentage change in PI were similar. Conclusion Resistive index and PI showed better post‐occlusion reliability than the more common measures of FMD or peak velocity and warrants further investigation.

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“…We did not examine the reproducibility of our FMD measurements; however, several studies examined the reproducibility of FMD by assessing intraclass correlation coefficient (ICC) [21,26,27,28,29]. …”

Section: Discussionmentioning

confidence: 99%

Brachial Artery Flow Mediated Dilation in the First Trimester to Predict the Occurrence of Hypertensive Disorders during Pregnancy

et al. 2015

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Objectives: To determine whether brachial artery flow-mediated dilation (FMD) assessed by ultrasonography during the late first trimester is able to predict the occurrence of hypertensive disorders during pregnancy. Methods: Maternal endothelial function was assessed by flow-mediated dilation (FMD) of the brachial artery in 487 pregnant women at 11-13⁺⁶ weeks' gestation. Subjects were prospectively followed and grouped according to the outcomes related to hypertensive disorders. We determined the areas under receiver operating characteristic (ROC) curve with their respective 95% confidence intervals (CI) for using low FMD results to predict the occurrence of hypertensive disorders during pregnancy. Results: Among 487 women, 9 (1.8%) were diagnosed with early-onset preeclampsia, 22 (4.5%) were diagnosed with late-onset preeclampsia, 47 (9.7%) developed gestational hypertension, and the remaining 409 (84%) pregnancies were unaffected by hypertensive disorders. Area under ROC curve analyses demonstrated that FMD was not able to predict pregnancies that developed hypertensive disorders. Conclusions: We conclude that FMD should not be considered a potential first-trimester marker of hypertensive disorders during pregnancy.

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Pulsatility Index Change of Brachial Artery Shows Better Reproducibility than Flow-Mediated Vasodilation

Cited by 8 publications

References 21 publications

Melatonin improves endothelial function in vitro and prolongs pregnancy in women with early‐onset preeclampsia

Melatonin improves endothelial function in vitro and prolongs pregnancy in women with early‐onset preeclampsia

Reliability of sonographic measurements of endothelial function: Flow‐mediated dilation, blood flow velocity, resistive and pulsatility indices

Brachial Artery Flow Mediated Dilation in the First Trimester to Predict the Occurrence of Hypertensive Disorders during Pregnancy

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