Lößner Charlotte, Multhaup Anna, Lehmann Thomas, Schleußner Ekkehard, Groten Tanja
Department of Obstetrics, University Hospital Jena, 07747 Jena, Germany.
Institute of Medical Statistics, Information Sciences and Documentation, University Hospital Jena, 07747 Jena, Germany.
J Clin Med. 2023 Feb 21;12(5):1719. doi: 10.3390/jcm12051719.
The evaluation of endothelial function is gaining interest and importance during pregnancy, since the impaired adaptation in early pregnancy has been associated with an increased risk in preeclampsia and fetal growth restriction. To standardize the risk assessment and to implement the evaluation of vascular function in routine pregnancy care, a suitable, accurate and easy to use method is needed. Flow-mediated dilatation (FMD) of the brachial artery assessed by ultrasound is considered to be the gold standard for measuring the vascular endothelial function. The challenges of the FMD measurement have so far prevented its introduction into clinical routine. The VICORDER device allows an automated determination of the flow-mediated slowing (FMS). The equivalence of FMD and FMS has not yet been proven in pregnant women. We collected data of 20 pregnant women randomly and consecutively while they presented for a vascular function assessment in our hospital. The gestational age at investigation was between 22 and 32 weeks of gestation, three had preexisting hypertensive pregnancy disease and three were twin pregnancies. The results for FMD or FMS below 11.3% were considered to be abnormal. Comparing FMD to FMS results in our cohort revealed a convergence in 9/9 cases, indicating normal endothelial function (specificity of 100%) and a sensitivity of 72.7%. In conclusion, we verify that the FMS measurement is a convenient, automated and operator-independent test method of endothelial function in pregnant women.
在孕期，内皮功能评估正变得越来越受关注且重要，因为孕早期适应功能受损与子痫前期和胎儿生长受限风险增加有关。为了规范风险评估并在常规孕期保健中开展血管功能评估，需要一种合适、准确且易于使用的方法。通过超声评估肱动脉的血流介导的血管舒张（FMD）被认为是测量血管内皮功能的金标准。FMD测量的诸多挑战至今阻碍了其应用于临床常规操作。VICORDER设备可自动测定血流介导的血流减慢（FMS）。FMD与FMS的等效性在孕妇中尚未得到证实。我们在20名孕妇到我院进行血管功能评估时，随机且连续地收集了她们的数据。检查时的孕周在妊娠22至32周之间，其中3名孕妇有既往高血压妊娠疾病，3名孕妇为双胎妊娠。FMD或FMS结果低于11.3%被视为异常。在我们的队列中比较FMD和FMS结果显示，9/9例结果一致，表明内皮功能正常（特异性为100%），敏感性为72.7%。总之，我们证实FMS测量是一种用于评估孕妇内皮功能的便捷、自动化且不依赖操作人员的检测方法。
