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Frequently Asked Questions
1.
What is the Arteriograph for?
2.
What does Arteriograph
measure? What is „Arterial stiffness”?
3.
What advantages does the
Arteriograph provide?
4.
What is the new measuring
method that makes the subject of the patent?
5.
Hoe does the Arteriograph
measure the arterial function parameters?
6.
What does the
„Pulse Wave Velocity (PWV)” and the
„Augmentation index (Aix)” mean?
7.
How do these parameters
relate to the condition of the vascular system?
8.
What stage of the vascular
and circulatory disturbances can these parameters be connected to?
9.
What kinds of other methods
can be used to determine these parameters?
10.
How did the validation of
the Arteriograph take place?
11.
How is an examination
taking place? What kind of qualification is necessary to perform the
examination?
12.
What do the findings of the
examination contain?
13.
What is to be done with
patients showing elevated or pathologic values?
14.
On what operational system
can TensioWin and Aretriograph software run?
15.
What are the possibilities
of education and consultation for users?
16.
On what fields of
specialization can the Arteriograph be applied with successes?
17.
What references are
available on this subject?
18.
Which companies are the official distributors of the products?
19.
To whom is it worth to buy
the device?
20.
What kind of aid can be given by the manufacturer and the distributor
for the users in the form of warranty and over the period of warranty?
21.
Are there
any other possibilities to get some more information?
1.
What is
the Arteriograph for?
The Arteriograph is a new Hungarian world patent that can be a turning
point in the early diagnosis of the atherosclerosis. It is capable of
measuring Central Blood Pressure, Small and Large Arterial Function in
a convenient 3 minutes test. By using this revolutionary system doctors
can make cardiovascular risk assessments significantly more accurate
even on a population level, having the potential of saving thousands of
lives.
2.
What does
Arteriograph measure? What is „Arterial stiffness”?
The Arteriograph examines the "age of the artery" that is the stiffness
of the arteries growing from strength to strength together with aging.
The state when the flexibility of the arteries is decreasing and they
are becoming stiffer and stiffer progressively is expressed in the
professional literature uniformly as "arterial stiffness".
3.
What
advantages does the Arteriograph provide?
Arterial function measurement was only available in clinical
environment, by using quite difficult methods, which needed skilled and
well-trained users. With its entirely new, oscillometric method,
Arteriograph provides an easy, fast, reliable and user-independent
method for measuring several arterial function parameters, as well as
central blood pressure values.
EASY, as an oscillometric blood pressure measurement
FAST, as it takes only 3 minutes (including patient data input)
USER INDEPENDENT, as it is fully automatic; the users only have to
launch the measurement.
RELIABLE, as its reproducibility and variance were shown to be superior
to other available methods.
4.
What is
the new measuring method that makes the subject of the patent?
The newly discovered measuring method used in the Arteriograph is based
on the fact that Dr. Illyés, Miklós and Mr.
Béres, József have found out the information
content of the signs appearing in the brachial artery during the
oscillometric measurement, carrying information regarding to
atherosclerosis. Not only is diagnose valid for the brachial artery,
but for the whole arterial system.
5.
Hoe does
the Arteriograph measure the arterial function parameters?
With use of a simple upper-arm cuff, the device is capable of
recording hemodynamic changes, which closely reflect central aortic
behaviour. For calculating arterial function parameters the recorded
blood pressure waveform is analyzed. First and reflected wave peaks and
dictrotic notch are defined, among others.The site of wave reflection
is in the vicinity of the bifuciration, i.e. the distance travelled by
the pulse wave is the true aortic length. The true aortic length is
estimated by the Jugulum symphysis distance, by which the calculation
of PWVao is enabled.
6.
What does
the „Pulse Wave Velocity (PWV)” and the
„Augmentation index (Aix)” mean?
At present, the aortic pulse wave velocity (PWV) and the so-called
augmentation index (Aix) are used mostly for the non-invasive
examination of the arterial stiffness.
In clinical practice, the pulse wave velocity (further on the PWV) is
generally understood as the PWV of the aorta, because this is where the
reduction of the flexibility of the vessel wall caused by the
atherosclerosis is present first of all. The aortic PWV can be
determined on the basis of the time difference of the pulse waves
appearing on the art. carotis and on the art. femoralis, as well as on
the basis of the velocity measured by the determination of the distance
between these two points, on the basis of the formula v=s/t.
The augmentation index, given in percents, (further on the Aix), is
defined as the pressure difference between the first (P1), the early,
(induced by the heart systole) and the second (P2), the late (appearing
because of the reflection of the first pulse wave) systolic peaks,
divided by the pulse pressure.
Aix (%) = (P2 - P1) / PP × 100
7.
How
do these parameters relate to the condition of the vascular
system?
The stiffer the wall of the aorta (atherosclerosis), the higher the PWV
value is. Value above 12 m/s is unambiguously accepted as pathologic,
because it has been proved that the survival rate with patients having
PWV value above this limit will significantly grow worse.
The Aix, first of all, gives information on the resistance of the
arterioles. The higher the percentage value of the Aix is, the stronger
the resistance of the arterioles (resistance vessels). Peripheral
resistance of the arterioles is essentially influenced by the
endothelium. In case of endothel dysfunction, the volume of the
nitrogen monoxide (NO) output in the endothelium will decrease, this is
the reason of its vasotonic effect, the peripheral resistance will grow
(further on TPR = Total Peripheral Resistance).
8.
What
stage
of the vascular and circulatory disturbances can these parameters be
connected to?
The atherosclerosis can already be demonstrated with the Arteriograph
in its earliest stage when the endothelin dysfunction is being
developed, because increased Aix values will be measured. The
Arteriograph can also be used to measure the later, macrovascular stage
of the atherosclerosis. In this case the increase of the aortic PWV
value can be observed
Attention! Increased aortic PWV value can also be caused by the
increase of the cardiac output!
9.
What kinds
of other methods can be used to determine these parameters?
Besides invasive methods, the PWV and Aix values can also be measured
with the so-called applanation tonometry. These devices can mutually be
characterized with the facts that their practical application is
complicated, time consuming and needs specially educated professionals.
These devices are applied mostly in special cardiological research
laboratories.
It can be said of the Arteriograph that it is a methodological turning
point, because with its simplicity and quickness, it offers a method
for a practicing physician to apply as a routine screening.
10. How
did
the validation of the Arteriograph take place?
On the one hand, the validation of the Arteriograph was made against an
invasive method at the Clinic of Cardiology of the Pécs
Medical University, where the pulse wave given by a cannula inserted
into the art. brachialis, and the wave given by the Arteriograph were
compared. It was demonstrated that the results gained by the
Arteriograph were totally the same as the intraarterial pulse waves
gained with the invasive method.
The PWV and the Aix values measured by the Arteriograph were also
validated to other, non-invasive measurement methods (Complior,
SphygmoCor). Both parameters show very close correlation (P = 0,8) with
the results measured with the above mentioned methods.
11.
How is an
examination taking place? What kind of qualification is necessary to
perform the examination?
The examination is fully automated and computerized. The task of the
operator is only to put the measuring cuff properly and to print out
the findings. Measuring with the Arteriograph will not necessitate any
special medical knowledge.
In the same time, it must be emphasized that the evaluation of the
findings and their proper interpreting in conjunction with the whole
clinical condition is unambiguously the task of the physician!
12. What do
the findings of the examination contain?
The Arteriograph, necessitating only a 3 minutes’ duration of
measuring, will provide with the following parameters:
Systolic blood pressure (SBP)
Diastolic blood pressure (DBP)
Mean arterial pressure (MAP)
Pulse pressure (PP)
Augmentation index (Aix)
Pulse wave velocity on the aorta (PWV)
Length of cardiac cycle in m/sec (Period)
Systolic area index (SAI)*
Diastolic area index (DAI)*
*The last two parameters give information on the perfusion pressure
state of the coronaries.
The measured Aix and PWV values are automatically evaluated by the
device according as they fall within the optimum, normal, elevated or
pathologic range of values.
13.
What is
to be done with patients showing elevated or pathologic values?
In case of patients showing elevated or pathologic values, a thorough
survey of all the other risk factors is indicated even if these
examinations showed negative results in the recent past.
Attention! It can lead to false negative results if the patient is
under strong effect of vasoactive medication (first of all under the
effect of nitrates, ACE-inhibitors).
14. On
what
operational system can TensioWin and Arteriograph software run?
TensioWin and Arteriograph software are capable of running under the
following operation systems:
Windows XP/Vista/7
Please contact us with any further questions conserning TensioMed
softwares.
15. What
are
the possibilities of education and consultation for users?
Taking into consideration that with the application of the
Arteriograph, quick information can be obtained on the basic
physiological and pathophysiological processes of the regularities of
the arterial circulation, one day of postgraduate professional course
is held monthly, and at the end of the course, the participants will
receive a diploma certifying their skills in the field of the
application of the Arteriograph.
Besides this, the findings can also be sent to the following e-mail
address for the purpose of consultation: info@tensiomed.com
16.
On what
fields of specialization can the Arteriograph be applied with successes?
The Arteriograph can provide powerful help for the representatives of
the following specializations during their preventive, diagnostic
interventions as well as when monitoring the effects of therapy:
- Professionals working in
occupational health (check-ups for atherosclerosis)
- General Practitioners (primary
check-up for atherosclerosis, and follow-up of the treatment)
- Cardiologists (non-invasive
hemodynamical monitoring, research work)
- Nephrologists (in case of
accelerating atherosclerosis is in connection with some renal problems)
- Diabetologists ( diabetes will
accelerate process of aging of the vessels)
- Obstetricians
and gynaecologists (the preeclampsia is an endothelial disease, the
menopause is a basic risk factor of atherosclerosis)
- Paediatric cardiologists (the
atherosclerosis is often detectable already in young age)
- Scientific researchers (in the
fields of physiology and pathophysiology)
- Experts in
pharmacodynamics at pharmaceutical factories (effect of the given
medicament to the TPR, the PWV or to the atherosclerosis)
17.
What
references are available on this subject?
Literature available on arterial stiffness nowadays is so large that it
can fill a library. Recommended choice of literature is available for
all who are interested.
18.
Which
companies are the official distributors of the products?
To become a distributor in a foreign country please contact
TensioMed Ldt.: info@tensiomed.com
19. To
whom
is it worth to buy the device?
It worths to buy to anybody working in the professions listed earlier.
According to our experiences, accomplishing checking up exams performed
by the Arteriograph for patients is highly recommended.
20.
What kind
of aid can be given by the manufacturer and the distributor for the
users in the form of warranty and over the period of
warranty?
Both the manufacturer and the distributors are present in the
international market having ISO qualification working in the system of
quality insurance. Both companies have brand services of their own.
They provide warranty period of 2 years for the basic instrument of the
Arteriograph. This can be done because the valves and pumps built in
the device comply with the highest requirements. Repair under warranty
generally means to replace the device.
21.
Are there
any other possibilities to get some more information?
For further help, continuously updated information is provided for our
customers and those who are interested on the website www.tensiomed.com. The new information data come from the
uninterruptedly growing number of customers and as results of the
ever-developing clinical research, which we are pleased to share with
you. Should you have any questions or requests, do not hesitate to
contact TensioMed Ltd. at info@tensiomed.com
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