Brachial artery pulsatility index change 1 minute after 5-minute forearm compression: comparison with flow-mediated dilatation

Wellington P Martins, Carolina O Nastri, Rui A Ferriani, Francisco Mauad Filho
Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine 2008, 27 (5): 693-9

OBJECTIVE: Endothelial impairment evaluation by sonographic measurement of flow-mediated dilatation (FMD) has become broadly used. However, this method has 2 main caveats: the dilatation depends on the baseline arterial diameter, and a high precision level is required. Vasodilatation leads to an amplified fall in impedance. We hypothesized that assessment of the pulsatility index change (PI-C) 1 minute after 5-minute forearm compression might evaluate that fall in impedance. The aim of this study was to compare the PI-C with FMD.

METHODS: Flow-mediated dilatation and the PI-C were assessed in 51 healthy women aged between 35.1 and 67.1 years. We correlated both FMD and the PI-C with age, body mass index, waist circumference, cholesterol level, high-density lipoprotein level, glucose level, systolic and diastolic blood pressure, pulse pressure, brachial artery diameter, simplified Framingham score, intima-media thickness, and carotid stiffness index. Intraclass correlation coefficients between 2 FMD and PI-C measurements were also examined.

RESULTS: Only FMD correlated with baseline brachial diameter (r = -0.53). The PI-C had a high correlation with age, body mass index, waist circumference, cholesterol level, systolic blood pressure, pulse pressure, simplified Framingham score, and intima-media thickness. The correlation between FMD and the PI-C was high (r = -0.66). The PI-C had a higher intraclass correlation coefficient (0.991) than FMD (0.836) but not brachial artery diameter (0.989).

CONCLUSIONS: The PI-C had a large correlation with various markers of cardiovascular risk. Additionally, PI-C measurement does not require offline analysis, extra software, or electrocardiography. We think that the PI-C could be considered a marker of endothelial function. However, more studies are required before further conclusions.

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