Sonographic flow-mediated dilation (FMD) imaging versus electronic EndoCheck flow-mediated slowing (FMS) by VICORDER in pregnant women - A comparison of two methods for the evaluation of vascular function in pregnancy.

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Charlotte Lößner, Anna Multhaup, Thomas Lehmann, Ekkehard Schleußner, Tanja Groten,

Journal of Clinical Medicine, 2023

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Topic

Comparison of FMD (Flow-Mediated Dilation Imaging) and FMS (Flow-Mediated Slowing by VICORDER to Evaluate Vascular Function in Pregnancy

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Abstract

‍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 of 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 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 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.

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Summary

The data demonstrate the high accordance of FMD and FMS results. We could validate that the FMS measuring by the VICORDER® is suitable for the routine care during pregnancy, yielding reliable clinical results.

 

Key Points

  • Comparable Results of the actual Gold Standard FMD and FMSs
  • Ease of Use: VICORDER allows an automated and operator-independent determination of vascular function.