scholarly journals 603 Endothelial dysfunction is associated with hypertensive disorder during pregnancy

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Carlo Maria Avallone ◽  
Martina Nuzzo ◽  
Irene Rota ◽  
Nicola Persico ◽  
Stefano Carugo ◽  
...  
Keyword(s):  
Brachial Artery ◽  
Vascular Reactivity ◽  
Resistance Index ◽  
Peak Systolic Velocity ◽  
First Trimester ◽  
Hypertensive Disorder ◽  
Mean Velocity ◽  
Brachial Artery Diameter ◽  
Diastolic Velocity ◽  
In Pregnancy

Abstract Aims Arterial hypertension (AH) is one of the main determinants of clinical disorders during pregnancy affecting 2% to 10% of pregnancies with a substantial public health impact. Both endothelial injury and increased vascular reactivity have been reported to be involved in the pathogenesis of pre-eclampsia syndrome. Abnormal patterns in brachial artery Doppler velocities have been shown to be predictive of pre-eclampsia in first trimester. The aim of this study is to investigate whether flow-mediated dilation (FMD) and Doppler flow derived-parameters can predict the occurrence of AH. Methods and results The study population consisted of pregnant women (mean age 32 years) who had been referred to the IRCCS Fondazione Ca’ Granda Policlinico of Milan. None of them had any medical issues and was taking any medications at the time of pregnancy. FMD was performed on left brachial artery according to expert recommendation. Measurements of brachial artery diameter and flow have been collected at rest, shortly before cuff release and then 5-, 15-, 30-, 60-, and 90-s during hyperaemia phase. Among Doppler measurements, systolic and diastolic velocity (Vs and Vd, respectively) as well as mean velocity (mean V) were considered. In addition, the pulsatility index (PI) and resistance index (RI) were calculated. A 3-months follow-up was planned in order to detect the presence of AH. All data were expressed as the median. U-test (Mann–Whitney analysis) was performed to test difference among hypertensives and non-hypertensives We recruited 48 women (median age 32 yeas) whose 4 (8.5%) developed AH during pregnancy. These latter had statistically significant higher systolic velocity measured at 5 s after the release of distal occlusion (126 cm/s vs. 173 cm/s; P < 0.05). No other velocity Doppler data [diastolic velocity (Vd), mean velocity (mean V), PI, RI, TAMAX, and TAMEAN] showed a statistical significant association with AH development. Conclusions The present study suggests that the vascular assessment through Doppler during FMD procedure may foresee the development of hypertensive disorder in pregnancy. Our result provides the first evidence that the peak systolic velocity of brachial artery may represent a marker of early endothelial activation or damage, that can be directly involved in the pathophysiological mechanisms of the hypertensive disorders in pregnancy.

195 Are the Spectral Doppler Indices of the Ovarian Arteries Predictive of Ovulatory Responses and Embryo Yields in Superovulated Ewes?

2018 ◽  
Vol 30 (1) ◽  
pp. 238
Author(s):  
M. E. F. Oliveira ◽  
Y. Tarasevych ◽  
W. R. R. Vicente ◽  
P. M. Bartlewski
Keyword(s):  
Resistance Index ◽  
Peak Systolic Velocity ◽  
Ovarian Response ◽  
Embryo Viability ◽  
Mean Velocity ◽  
Ovarian Artery ◽  
Diastolic Velocity ◽  
Spectral Doppler ◽  
Left And Right ◽  
Doppler Indices

Increased uterine and ovarian blood flow seems to be related to the effectiveness of ovarian response to hormonal superstimulation in mares (Witt et al. 2012 Theriogenology 77, 1406-1414). Similar studies do not exist for sheep. Nineteen Santa Inês ewes were subjected to a 9-day CIDR® priming and superovulatory (SOV) treatment with 200 mg of porcine (p)FSH per ewe given twice daily for 4 consecutive days in decreasing doses and initiated 6 days after CIDR® insertion. Ten ewes received an IM injection of oestradiol benzoate (EB, 350 μg) at the time of CIDR® insertion (group E); the remaining animals served as controls (group C). The ewes were placed in a pen with rams for 3 days after CIDR® removal. The embryos were recovered surgically 6 days after the CIDR® removal. Transrectal ultrasonographic examinations (Doppler mode) using MyLab VET 30 scanner (Esaote, Genoa, Italy) equipped with a linear-array (6- to 8-MHz) transducer were performed once a day throughout the SOV treatment (Days 1 to 4) to determine the velocimetric indices of the left and right ovarian arteries: flow velocity integral (FVI); peak systolic velocity (SVp); mean velocity (Vm); end-diastolic velocity (EDV); vascular resistance index [RI = (SVp – EDV)/SVp]; and pulsatility index [PI = (SVp – EDV)/Vm]. All spectral data were obtained from a longitudinal subovarian segment of the ovarian artery using a gate ranging from 2 to 3 mm (~two-thirds of the vessel’s diameter) and insonation angle ≤60°. There were no differences (P > 0.05) in ovarian responses and embryo yields/quality between left and right ovaries/uterine horns flashed or between EB-treated and control ewes. Mean EDV and Vm were greater (P < 0.05) in group C compared with group E on Days 1 and 2, and mean Vp was greater (P < 0.05) in group C ewes on Day 3 of the SOV treatment. In group E, there were 5 significant correlations between the spectral Doppler indices (RI, PI, and EDV) of the ovarian arteries recorded on Days 2 and 4 and SOV responses (numbers of degenerated embryos, unfertilized eggs, and luteinized unovulated follicles characterised by a lack of ovulatory stigmata). In group C, 7 significant correlations were found between Vp, EDV, Vm, and RI on Days 1, 2, and 3 and numbers/percentages of degenerated embryos, numbers of prematurely regressed luteal structures (pale, ≤5 mm in diameter), and embryo viability rates (percentage of transferrable quality embryos). When ultrasonographic and SOV data were analysed separately for the left and right ovarian artery/uterine horn, multiple significant correlations were found between the velocimetric indices and SOV responses but they varied among days, the 2 ovaries, and the 2 groups of animals studied. These results may be interpreted to suggest that intrinsic gonadal factors remain a significant barrier precluding the prediction of SOV outcomes from haemodynamic changes in ovine ovarian arteries. Velocimetric indices determined in the ovarian arteries appear to have limited prognostic value during the application of different SOV protocols in ewes.

scholarly journals Post-exercise pulsatility index indicates treatment effects in peripheral arterial occlusive disease (PAOD)

2021 ◽  
Author(s):  
Andrej Udelnow ◽  
Maria Hawemann ◽  
Ivo Buschmann ◽  
Frank Meyer ◽  
Zuhir Halloul
Keyword(s):  
Repeated Measures ◽  
Pulsatility Index ◽  
Treatment Effects ◽  
Resistance Index ◽  
Peak Systolic Velocity ◽  
Arterial Tree ◽  
Post Exercise ◽  
Diastolic Velocity ◽  
Before And After ◽  
Healthy Persons

Summary Background Hypothesis: Post-exercise measurements better discriminate PAOD-patients from healthy persons and they more sensitively detect hemodynamic improvements after treatment procedures than resting measurements. Methods A total of 19 healthy volunteers and 23 consecutive PAOD-patients underwent measurements of peak systolic velocity (PSV), end-diastolic velocity (EDV), minimal diastolic velocity (MDV), time-averaged maximum velocities (TAMAX), resistance index (RI) and pulsatility index (PI) before and after a standard exercise test (at 1, 2, 3, 4 and 5 min) before and after treatment (incl. epidemiological data, PAOD risk factors and comorbidities). Results In resting values, healthy persons and PAOD-patients did not differ significantly in any of the hemodynamic parameters. PSV increased after treatment in PAOD-patients by 5 cm/s (paired t‑test, p: 0.025); however, when the amplitude of autoregulatory changes related to the resting values were calculated, PAOD-patients showed clearly less hemodynamic changes after exercise than healthy persons (p: 0.04; 0.002; <0.001 for PSV, TAMAX and PI, resp.). The time course after exercise was compared by repeated measures of ANOVA. Healthy persons differed significantly in PI, RI and PSV from PAOD patients before and after treatment (p<0.001 each). The PAOD-patients revealed a significantly improved PI after treatment (p: 0.042). The only factor contributing significantly to PI independently from grouping was direct arterial vascularization as compared to discontinuous effects by an obstructed arterial tree. Conclusion Healthy persons cannot be well differentiated from PAOD-patients solely by hemodynamics at rest but by characteristic changes after standard exercise. Treatment effects are reflected by higher PI-values after exercise.

Normal pregnancy is associated with enhanced endothelium-dependent flow-mediated vasodilation

1999 ◽  
Vol 276 (3) ◽  
pp. H821-H825 ◽  
Author(s):  
Inge Dørup ◽  
Kristjar Skajaa ◽  
Keld E. Sørensen
Keyword(s):  
Brachial Artery ◽  
Reactive Hyperemia ◽  
Peripheral Resistance ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Brachial Artery Diameter ◽  
Vasomotor Function ◽  
Pregnancy Status ◽  
Dependent Flow ◽  
Flow Mediated Vasodilation

Normal pregnancy is characterized by reduced systemic vascular resistance, which may be mediated by nitric oxide (NO). We compared endothelial vasomotor function in 71 normal pregnant women (13 in first, 29 in middle, and 29 in last trimester) to 37 healthy age-matched controls. With external ultrasound, brachial artery diameter was measured at rest, during reactive hyperemia [with increased flow causing endothelium-dependent dilation (FMD)], and after sublingual nitroglycerin (causing endothelium-independent dilation). Compared with controls, resting flow and brachial artery diameter were significantly higher during the middle and last trimesters. Reactive hyperemia was reduced in all pregnant groups. FMD increased from the first trimester (by 26%), reaching the highest value in the last trimester (to 47% above nonpregnant values). FMD was significantly correlated to pregnancy status (nonpregnant or pregnant) and to vessel size. Nitroglycerin-induced dilation was similar in pregnant and nonpregnant women. A longitudinal study of eight women evaluated in the first, middle, and last trimesters confirmed an increase in FMD throughout pregnancy. The study supports the idea that basal and stimulated NO activity is enhanced in normal pregnancy and may contribute to the decrease in peripheral resistance.

scholarly journals Late diagnosis of pheochromocytoma in pregnancy with poor fetal outcome

2021 ◽  
Vol 27 (1) ◽  
pp. 9-11 ◽  
Author(s):  
Gauri Bapayeva ◽  
Milan Terzic ◽  
Karlygash Togyzbayeva ◽  
Aigerim Bekenova ◽  
Sanja Terzic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Gestational Hypertension ◽  
Fetal Lung ◽  
Abdominal Ultrasound ◽  
First Trimester ◽  
Maternal Blood ◽  
Fetal Outcome ◽  
Hypertensive Disorder ◽  
Emergency Cesarean ◽  
In Pregnancy

Pheochromocytomas are rare tumors producing catecholamines that could be a cause of secondary hypertension. On that basis, pheochromocytoma can occur as an extremely rare cause of hypertension in pregnancy and if diagnosed late can lead to adverse maternal-fetal outcome. In this case report we describe a case of pheochromocytoma affected pregnancy with poor fetal outcome. A 27-year-old pregnant woman was admitted for severe pre-eclampsia due to pre-gestational hypertension that was diagnosed during the first trimester. Due to high and uncontrolled maternal blood pressure and the worsened maternal-fetal condition after the admission induction of fetal lung maturity and emergency cesarean section were performed, but with poor fetal outcome. Later, an adrenal gland mass was identified using abdominal ultrasound and confirmed by computed tomography. After surgical adrenalectomy blood pressure of the patient was normalized. Pheochromocytoma should be considered as a possible cause of hypertensive disorder during pregnancy, particularly in cases of severe and unresponsive hypertension in order to provide for timely and appropriate treatment.

scholarly journals A blood-mimicking fluid with cholesterol as scatter particles for wall-less carotid artery phantom applications

2021 ◽  
Vol 21 (86) ◽  
pp. e219-e224
Author(s):  
Kyermang Kyense Dakok ◽  
◽  
Mohammed Zubir Matjafri ◽  
Nursakinah Suardi ◽  
Ammar Anwar Oglat ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Physical Properties ◽  
Peak Systolic Velocity ◽  
Artery Wall ◽  
Mean Velocity ◽  
Polystyrene Microsphere ◽  
Carotid Artery Wall ◽  
Diastolic Velocity ◽  
Frequency Peak ◽  
Ultrasound Applications

Aim of the study: At present, there are few scatter particles used in preparing blood-mimicking fluids, such as nylon, sephadex, polystyrene microsphere, and poly(4-methystyrene). In this study, we present cholesterol as a new scatter particle for blood-mimicking fluid preparation. Materials and methods: The procedure for the preparation of the proposed blood-mimicking fluid involved the use of propylene glycol, D(+)-Glucose and distilled water to form a ternary mixture fluid, with cholesterol used as scatter particles. Polyethylene glycol was first used as part of the mixture fluid but the acoustic and physical properties were not suitable, leading to its replacement with D(+)-Glucose, which is soluble in water and has a higher density. A common carotid artery wall-less phantom was also produced to assess the flow properties. Results: The prepared blood-mimicking fluid with new scatter particles has a density of 1.067 g/cm3, viscosity of 4.1 mPa.s, speed of sound 1600 m/s, and attenuation of 0.192 dB/cm at 5 MHz frequency. Peak systolic velocity, end diastolic velocity and mean velocity measurements were gotten to be 40.2 ± 2.4 cm/s, 9.9 ± 1.4 cm/s, and 24.0 ± 1.8 cm/s, respectively. Conclusion: Based on the results obtained, the blood-mimicking fluid was found suitable for ultrasound applications in carotid artery wall-less phantoms because of its good acoustic and physical properties.

PROSPECTIVE STUDY OF ALTERATION IN TESTICULAR PERFUSION AND VOLUME IN LAPAROSCOPIC TOTALLY EXTRAPERITONEAL HERNIA REPAIR

2021 ◽  
pp. 122-124
Author(s):  
Sajad Hussain Malik ◽  
Ferkhand Mohi Ud Din ◽  
Hanief Mohammad Dar ◽  
Irshad Ahmad Kumar
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Prospective Study ◽  
Tertiary Care ◽  
Resistance Index ◽  
Peak Systolic Velocity ◽  
Testicular Volume ◽  
Care Hospital ◽  
Diastolic Velocity ◽  
Testicular Perfusion

PURPOSE:- The objective of this study was to assess the effect of Totally extra-peritoneal inguinal hernia repair on testicular perfusion and testicular volume. METHODS: - After obtaining ethical clearance from institutional ethical committee, the present Prospective study was conducted on 48 male patients with unilateral inguinal hernia in a tertiary care hospital. RESULTS: - The study was conducted on 48 patients over a period of 2 years from august 2017 to august 2019 after meeting inclusion and exclusion criteria. Their mean age was 45.70 years (range 21-72 years). In our study comparison of preoperative and postoperative values at third and sixth month in the patients did not show any statistically signicant alteration in the variables studied like testicular volume (p-0.987) and blood ow perfusion parameters Peak systolic velocity (p-0.591); End Diastolic velocity (p-0.526); Resistance index (p-0.415). CONCLUSION: - No alteration in testicular volume and arterial ow over a six-month period was observed among patients who underwent laparoscopic extra-peritoneal surgical correction using polypropylene prosthesis for inguinal hernia

SONOGRAPHIC FINDINGS OF PATIENTS WITH CHRONIC KIDNEY DISEASE

2017 ◽  
pp. 109-113
Author(s):  
Ba Lai Luu ◽  
Thanh Thao Nguyen
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Artery ◽  
Glomerular Filtration ◽  
Resistance Index ◽  
Peak Systolic Velocity ◽  
Kidney Size ◽  
Healthy Group ◽  
Diastolic Velocity ◽  
Significant Difference

Objective: To describe the morphologic and hemodynamic changes of renal interlobar artery on ultrasonography, and to evaluate the relationship between RI and kidney size, glomerular filtration rate, and causes of chronic kidney disease. Materials and methods: A cross-sectional study of 50 chronic kidney disease patients from stage 3, and 50 healthy individuals. RI, peak systolic velocity (PSV), end diastolic velocity (EDV) of renal interlobar artery, renal size was measured. Results: The mean RI in chronic kidney disease group and healthy group was 0.68 ± 0.05 and 0.57 ± 0.04 (p <0.05), respectively. RI increases with the stage of chronic kidney disease. There were statistically significant differences in RI of renal lobar arteries between chronic pyelonephritis and chronic glomerulonephritis (p <0.05). There was strong negative correlation and a statistically significant difference between renal lobar renal artery RI with kidney size (horizontal, vertical and thickness) and glomerular filtration level. Conclusion: Renal artery resistance index in patients with chronic kidney disease was higher than in the healthy group. The greater the kidney failure is, the more reduction in size and renal function, and the more increase in renal artery resistance index. Key words: morphologic, hemodynamic, chronic kidney disease, ultrasonography

scholarly journals The Renal Arterial Resistance Index Predicts Worsening Renal Function in Chronic Heart Failure Patients

2016 ◽  
Vol 7 (1) ◽  
pp. 42-49 ◽  
Author(s):  
Massimo Iacoviello ◽  
Francesco Monitillo ◽  
Marta Leone ◽  
Gaetano Citarelli ◽  
Annalisa Doronzo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Chronic Heart Failure ◽  
Multivariate Logistic Regression Analysis ◽  
Resistance Index ◽  
Peak Systolic Velocity ◽  
Cardiorenal Syndrome ◽  
Arterial Resistance ◽  
Worsening Renal Function ◽  
Diastolic Velocity

Background/Aim: The renal arterial resistance index (RRI) is a Doppler measure, which reflects abnormalities in the renal blood flow. The aim of this study was to verify the value of RRI as a predictor of worsening renal function (WRF) in a group of chronic heart failure (CHF) outpatients. Methods: We enrolled 266 patients in stable clinical conditions and on conventional therapy. Peak systolic velocity and end diastolic velocity of a segmental renal artery were obtained by pulsed Doppler flow, and RRI was calculated. Creatinine serum levels were evaluated at baseline and at 1 year, and the changes were used to assess WRF occurrence. Results: During follow-up, 34 (13%) patients showed WRF. RRI was associated with WRF at univariate (OR: 1.13; 95% CI: 1.07-1.20) as well as at a forward stepwise multivariate logistic regression analysis (OR: 1.09; 95% CI: 1.03-1.16; p = 0.005) including the other univariate predictors. Conclusions: Quantification of arterial renal perfusion provides a new parameter that independently predicts the WRF in CHF outpatients. Its possible role in current clinical practice to better define the risk of cardiorenal syndrome progression is strengthened.

FEATURES OF RENAL BLOOD FLOW IN PATIENTS WITH MULTIPLE MYELOMA AT DIFFERENT STAGES OF TUMOR PROGRESSION

2016 ◽  
Vol 1 (61) ◽  
pp. 52-58 ◽  
Author(s):  
Макарова ◽  
Natalya Makarova
Keyword(s):  
Multiple Myeloma ◽  
Blood Flow ◽  
Tumor Progression ◽  
Vascular Resistance ◽  
Resistance Index ◽  
Peak Systolic Velocity ◽  
Renal Hemodynamics ◽  
Renal Arteries ◽  
Diastolic Velocity ◽  
Segmental Arteries

The features of renal hemodynamics in 90 patients with multiple myeloma (MM) at different stages of tumor progression have been studied. The signs of renal hemodynamics disorder by ultrasound Dopplermetry data are already revealed at the first stages of MM. In the I and IIA stages there were diagnosed the following changes: the increase in average blood flow velocity (Vave) at the level of the interlobular arteries (20%); the reduction of peak systolic velocity (Vmax) at the level of arteries arc (11.4%); the drop of Vmax (24.5%), of Vave (11%), of diastolic velocity (Vmin) by 26% on interlobular arteries; the decrease of Vmin (26%) on segmental and main renal arteries. There was also revealed an increase in the indices of vascular resistance index (IR by 11%, IP by 13%) and main renal arteries (IR by 12%, IP by 16%). Under disease progression in IIIA stage there was: the growth of Vmax (21.5%), Vave (24.9%), Vmin (42.7%) on interlobular arteries; the decrease of Vave (24.8%), Vmin (51.5%) on interlobular renal arteries. The decrease of IR on interlobular arteries (9%) and its increase at the level of segmental and main renal arteries (11%) were diagnosed. The biggest changes in the blood flow by Dopplermetry data were diagnosed in MM patients at chronic renal disease (IІ and IIIB stages): the reduction of speed indicators on interlobular arteries – Vmax (26%), Vave (42%), Vmin (44%); on arc arteries – Vmax (29%), Vave (21%), Vmin (38%); on interlobar arteries – Vmax (30%), Vave (39%), Vmin (46%); on segmental arteries – Vmax (17%), Vave (22%), Vmin (42%); on the main renal artery – Vmax (11%), Vmin (33%). An increase in the indices of vascular resistance was revealed: IR on interlobular arteries (11%), the arc arteries (12%), interlobular arteries (11%), segmental arteries (13%), the main renal arteries (11%); IP on interlobular arteries (13%), the arc arteries (12%), interlobular arteries (13%), segmental arteries (12%), the main renal arteries (12%). These parameters correspond to Doppler criteria of chronic renal insufficiency of compensated stage.

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