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Updated: Jul 24, 2026
Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
Published on: October 22, 2014
Wave reflections in fibromuscular dysplasia provides insights into the vascular pathophysiology
Smriti Badhwar1,2, Stefan Orter3,4, Christopher C Mayer3
1Université de Paris Cité, Paris Centre de Recherche Cardiovasculaire (PARCC), INSERM.
Background:
Fibromuscular dysplasia (FMD) is a nonatherosclerotic, multiarterial disease with unknown aetiology. The aim of this study was to comprehensively evaluate arterial stiffness, wave reflections and local arterial wall remodelling in patients with FMD and blood pressure-matched essential hypertensives (HTN).
Methods:
Carotid and aortic wave separation and wave intensity analysis was performed in patients with FMD [n = 16, (14 women)], age and blood-pressure matched HTN [n = 21, (18 women)] and age-matched healthy individuals [n = 22, (19 women)]. Carotid and aortic pressure waveforms were acquired using tonometry. Carotid blood flow and diameter were measured using B-mode and doppler respectively and aortic flow using the ARCSolver algorithm.
Results:
Carotid backward wave amplitude was comparable between HTN and FMD 14.82 ± 4.71 vs. 13.45 ± 5.36 mmHg, P = 0.13) but higher in HTN compared to healthy individuals (11.69 ± 3.78 mmHg, P = 0.03). Carotid backward compression wave intensity [FMD -5.68 (-9.32 to 3.23), HS -6.43 (-8.58 to 3.59), HTN -8.38 (-11.46 to 5.37) mmHg*m/s3*10-2) and energy (FMD 0.33 (0.21-0.46), healthy individuals 0.35 (0.24-0.52), HTN 0.43 (0.29-0.66) mmHg*m/s2*10-2] was also higher in HTN compared to healthy individuals (P = 0.04 and 0.02) and FMD (P = 0.006 and <0.001), respectively. Aortic backward wave amplitude and wave intensity energy were higher in patients with FMD compared to healthy individuals but comparable to HTN.
Conclusion:
The results indicate that, despite similar blood pressure, wave reflections at carotid are higher in patients with essential HTN compared to FMD indicating greater flow transmission to the cerebral circulation in FMD. Second, wave reflections at aortic level are higher, potentially increasing risk of cardiovascular disease in these patients.
