Ophthalmic artery Doppler in prediction of pre‐eclampsia: insights from hemodynamic considerations

Abstract

Linked article: This Correspondence comments on Sapantzoglou et al. and Sarno et al.

Comparison of ophthalmic artery Doppler with PlGF and sFlt‐1/PlGF ratio at 35–37 weeks' gestation in prediction of imminent pre‐eclampsia

“…In women that developed PE, the ophthalmic artery PSV ratio was increased compared with unaffected cases, and the degree of the increase was associated inversely with gestational age at delivery with PE. We found that there was a small increase in PSV1 in PE compared with unaffected cases, possibly reflecting a small increase in cardiac output, and a considerably greater increase in PSV2, suggesting that the high PSV ratio is mainly due to increased peripheral vascular resistance 17,18 .…”

“…The first systolic wave (PSV1) is created by cardiac systole, with the opening of the aortic valve and ejection of blood into the aorta, whilst the second systolic wave (PSV2) is a reflective wave formed by the systolic pulse wave reaching smaller, higher-resistance arterioles and being reflected back towards the heart. At the level of the aortic arch, a fraction is diverted cranially to the cerebral circulation as a forward wave to create PSV2 17,18 . In this way, PSV2 is most influenced by peripheral arterial compliance and resistance, whilst PSV1 is more affected by cardiac output.…”

Changes in ophthalmic artery Doppler during acute blood‐pressure control in hypertensive pregnant women

“…The PSV ratio is the interplay between PSV1 and PSV2. PSV1 is created by cardiac systole, generating a rapid upstroke to reach systolic peak pressure 27 , whereas, PSV2 is created by reflection of the systolic wave as it encounters the higher resistance of smaller arterioles 28 . Specifically, the wave is reflected back towards the aortic arch, where a fraction is diverted cranially to the cerebral circulation as a forward wave, to create the second systolic peak (PSV2) 28 .…”

Association of ophthalmic artery Doppler and maternal cardiac changes in preclinical stage of pre‐eclampsia: hemodynamic relationship

“…Effect on cerebral arteries. At the level of the aortic arch, a fraction of the RW turns cranially and continues as a forward wave to generate a second systolic velocity peak (P2) in the cerebral arteries [1][2][3] and, in particular, in the OA 14 , if reflection is strong enough. The amplitude of P2 is related to the intensity of the RW, and OA-PR might serve as a relative measure of the reflection intensity.…”