Isabel María Rodríguez García

Doppler ultrasound in the measurement of pulse wave velocity: agreement with the Complior method

Aortic stiffness is an independent predictor factor for cardiovascular risk. Different methods for determining pulse wave velocity (PWV) are used, among which the most common are mechanical methods such as SphygmoCor or Complior, which require specific devices and are limited by technical difficulty in obtaining measurements. Doppler guided by 2D ultrasound is a good alternative to these methods. We studied 40 patients (29 male, aged 21 to 82 years) comparing the Complior method with Doppler. Agreement of both devices was high (R = 0.91, 0.84-0.95, 95% CI). The reproducibility analysis revealed no intra-nor interobserver differences. Based on these results, we conclude that Doppler ultrasound is a reliable and reproducible alternative to other established methods for the measurement of aortic PWV.

The Relationship Between Renal Resistive Index, Arterial Stiffness, and Atherosclerotic Burden: The Link Between Macrocirculation and Microcirculation

The renal resistive index (RRI) measured by Doppler sonography is a marker of microvascular status that can be generalized to the whole of the arterial tree. Its association with large‐vessel dysfunction, such as arterial stiffness or the atherosclerotic burden, can help to establish physiopathological associations between macrocirculation and microcirculation. The authors conducted a cross‐sectional study of hypertensive patients (n=202) and a healthy control group (n=16). Stiffness parameters, atherosclerotic burden, and determination of the RRI in both kidneys were performed. The average RRI was 0.69±0.08 and was significantly greater in patients with diabetes and chronic kidney disease. Renal resistive index positively correlated with age, creatinine, and albuminuria. Positive correlations were found with arterial stiffness parameters (pulse wave velocity, ambulatory arterial stiffness index, and 24‐hour pulse pressure), as well as atherosclerotic burden and endothelial dysfunction measured as asymmetric dimethylarginine in serum. In the multivariate analysis, independent factors for increased RRI were age, renal function, 24‐hour diastolic blood pressure, and arterial stiffness. The authors concluded that there is an independent association between renal hemodynamics and arterial stiffness. This, together with the atherosclerotic burden and endothelial dysfunction, suggests that there is a physiopathologic relationship between macrovascular and microvascular impairment.

Análisis de la tasa de detección mediante ecografía de fetos con crecimiento intrauterino restringido y pequeño para la edad gestacional

Objetivo: Analizar la tasa de deteccion de fetos pequenos para la edad gestacional (PEG) y crecimiento intrauterino restringido (CIR) mediante exploracion ecografica. Metodo: Estudio retrospectivo de casos y controles. Recien nacidos (RN) de gestaciones unicas a termino (entre la semana 37-42) en el Hospital Universitario San Cecilio entre 2009 y 2010. Grupo casos: 98 RN a termino con peso al nacer < 2500 g, con peso fetal estimado (PFE) por ecografia en el III trimestre. Grupo control: 100 RN durante el mismo periodo con peso al nacer entre 3000-4000 g, con PFE por ecografia en el III trimestre obtenido de forma aleatoria. Resultados: La tasa de deteccion de CIR tipo I fue de un 11,1% con una incidencia del 0,1% y la tasa de deteccion de pequenos para edad gestacional fue de un 56,5% con una incidencia del 2% respecto al total de RN. Conclusion: En nuestra experiencia la EPF mediante ecografia en fetos con peso bajo el p10 tiene un error de 6% respecto al peso neonatal, esto permite una adecuada identificacion de fetos con PEG y CIR.