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Flow-mediated dilation in brachial artery in the second half of pregnancy and prediction of pre-eclampsia

Journal of Human Hypertension volume 17, pages 697–704 (2003)Cite this article

Abstract

Endothelial injury and increased vascular reactivity are involved in the pathogenesis of pre-eclampsia (pregnancy-induced hypertension). To investigate whether flow-mediated dilation (endothelium-dependent dilation) and the reactive hyperemic response can predict pre-eclampsia, we prospectively measured flow-mediated dilation and the Doppler flow velocity pattern (V, cm/s) in the brachial artery using high-resolution ultrasound in 43 pregnant women (32±5 years old) in the second half of their pregnancy, and compared the findings with traditional risk factors. Regarding the Doppler flow velocity pattern, the pulsatility index (PI)=(systolic V−diastolic V)/mean V and resistance index (RI)=(systolic V−diastolic V)/systolic V were calculated. For the flow-mediated dilation, the per cent diameter changes were determined based on those from baseline to hyperemic conditions. Nine women suffered from pre-eclampsia and 34 women remained normotensive. Only flow-mediated dilation was found to be significantly lower in the subsequently developed pre-eclampsia patients (1.6±1.0% in subsequently developed pre-eclampsia patients vs 11.0±4.5% in normotensive patients, P<0.05). Neither the other traditional factors nor the Doppler flow velocity pattern were significantly different between the subsequently developed pre-eclampsia and normotensive patients. If a normal cutoff value of 3.0% obtained from age-matched 14 nonpregnant women (32±7 years old) in our laboratory was used, the positive predictive value of flow-mediated dilation (<3.0%) for subsequent pre-eclampsia is 90% and the negative predictive value is 100%. In conclusion, flow-mediated dilation in brachial artery can be a simple and noninvasive modality to predict pre-eclampsia.

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Authors and Affiliations

  1. National Defense Medical College, Internal Medicine-1, Saitama, Japan

    B Takase, A Hamabe, A Uehata & K Satomura

  2. National Defense Medical College, Obsetrics, Saitama, Japan

    T Goto, K Kuroda & F Ohsuzu

  3. Research Center, National Defense Medical College, Saitama, Japan

    A Kurita

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  1. B Takase
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  2. T Goto
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  3. A Hamabe
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  4. A Uehata
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  7. F Ohsuzu
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Correspondence to B Takase.

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Takase, B., Goto, T., Hamabe, A. et al. Flow-mediated dilation in brachial artery in the second half of pregnancy and prediction of pre-eclampsia. J Hum Hypertens 17, 697–704 (2003). https://doi.org/10.1038/sj.jhh.1001599

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