The role of endothelial dysfunction (ED) in cardiovascular disease pathogenesis has been actively studied in the past thirty years.
OBJECTIVE
To study the dynamics of blood flow velocity in the brachial artery during an occlusion test and develop the ED diagnostic criteria based on Doppler peak systolic velocity (PSV) of blood flow.
MATERIALS AND METHODS
The study involved 95 women. The observation arm included 34 patients with endothelium-dependent vasodilation (EDVD) <10%, and the comparison arm comprised 61 patients with EDVD ≥10%. A compression test was performed using the D.S. Celermajer method. The blood flow PSV was registered 5 seconds after decompression, then every 5 seconds till 45 seconds after decompression. The brachial artery diameter was measured at 45—60 seconds after decompression. We compared each PSV to the PSV value at the 5th second.
RESULTS
Considering the average rank value, the PSV ratios to the maximum level were higher in the observation arm than in the comparison arm. The multivariate logistic regression revealed the statistical significance for ED of the blood flow PSV ratios to the maximum level at the 10th and 45th seconds after cuff decompression. ROC analysis demonstrated a good quality of models concerning ED.
CONCLUSIONS
The observation arm had a higher relative peak systolic blood flow velocity (to the values at the 5th second) at each cut-off point from the 10th to the 45th second after cuff decompression. A logistic model of endothelial dysfunction based on the degree of decrease in peak systolic blood flow velocity after cuff decompression has a good predictive quality. Introducing this model would allow for the detection of endothelial dysfunction by measuring the peak systolic blood flow velocity.