Pulsed Doppler: determination of diameter, blood flow velocity, and volumic flow of brachial artery in man

This paper has a story. With my friends, Dr London and Levy, I was just beginning to develop the subjects of large arteries in hypertension. Dr Simon, who at this period worked in my group, was studying Windkessel models to see whether they could be applicable to clinical situations [1]. I visited my friend, Dr Tarazi, in Cleveland and I was waiting for him in his office. There was on his desk some “White books” on cardiovascular research in hypertension, which were written by NYHA authors. I noted that ultrasound techniques were recently developed to measure the internal diameter of superficial arteries as the brachial artery. The name of the bioengineer responsible for the research was Pierre Peronneau. Returning to Paris, I learnt that Pierre Peronneau worked in my hospital, that the device was known by many of my colleagues, but that no validation had yet been performed after several years. On the advice of Pierre Peronneau and of Dr Diebolt, a cardiologist of Broussais Hospital specialized in ultrasound techniques, I decided to develop the validation, which was then published in Cardiovascular Research under the first signature of Dr Levenson. Our main goal was to develop such measurements not only in pathophysiology but rather in clinical pharmacology and therapeutics of hypertension [2]. Indeed, we published at the same period several works [3,4] and suggested that structural changes of the large arteries were involved in the mechanisms of hypertension independently of age and atherosclerosis and that these findings had important connections with the results of the first therapeutic trials published on cardiovascular morbidity and mortality in hypertension. In the next years, no further ultrasound work enabling arterial diameter measurements was done in France. However, Mr Arnold Hoeks, who had previously worked with Prof. Peronneau, was developing new methodologies with Prof. Reneman in Maastricht. I was in contact with them through Prof. Struijker Boudier and Prof. Rahn, also from Maastricht, who were the first in Europe to invite me to present the results of my group on compliance changes in hypertension. Thus in association with Drs London and Levy [5,6], we continued such work with the group from Maastricht. We were joined by G. Mancia and H. Brunner, who were at the origin of novel methods developed in Lausanne. As it may be seen, all these men were already or became brilliant research workers on the subjects of large arteries in the next 10 to 15 years and developed important applications in pulsatile hemodynamics, molecular biology, genetics and epidemiology of hypertension. The editors gratefully acknowledge help in final preparation of the manuscript by Mrs. Anne van der Valk.