title: A comparison of Doppler waveform parameters versus flow-mediated vascular dilation of the brachial artery in pregnant women.
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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Stony Brook Department of Obstetrics and Gynecology, 6 Technology Drive, Suite 200, East Setauket, NY 11733, United States.
authors.forename: Inna V
authors.initials: IV
authors.lastname: Landres
authors.affiliation: Department of Obstetrics and Gynecology, Duke University Medical Center, DUMC 3967, Durham, NC 27710, United States.
authors.forename: Maria
authors.initials: M
authors.lastname: Small
authors.affiliation: Department of Obstetrics and Gynecology, Mount Hope Maternity Hospital, University of the West Indies, Trinidad and Tobago.
authors.forename: Adesh
authors.initials: A
authors.lastname: Sirjusingh
authors.affiliation: Department of Obstetrics and Gynecology, Mount Hope Maternity Hospital, University of the West Indies, Trinidad and Tobago.
authors.forename: Samuel
authors.initials: S
authors.lastname: Ramsewak
authors.affiliation: Department of Obstetrics and Gynecology, Rowan University - School of Osteopathic Medicine, Stratford, NJ, United States. Electronic address: williakp@rowan.edu.
authors.forename: Keith P
authors.initials: KP
authors.lastname: Williams
keywords: Brachial artery waveform; Doppler ultrasound; Endothelial dysfunction; Flow mediated vascular dilation