Arteriograph Improves Cardiovascular Risk Assessments

Arterial Stiffness assessment

The term “Cardiovascular disease” (CVD) refers to a group of health conditions affecting the heart or blood vessels. CVD is one of the primary causes of death and disabilities worldwide, contributing to 32% of all global deaths. The possibility of preventing these diseases is greatly improved by leading a healthy lifestyle and screening the cardiovascular condition of the patient regularly.

The main part of above-mentioned assessments is to measure central hemodynamic parameters. Aortic Pulse Wave Velocity (PWVao), Augmentation Index (AIx), Central Systolic Blood Pressure (SBPao) each are part of a great puzzle, helping through better understanding of the most crucial organisation in the human body which is cardiovascular system.

The necessity for a non-invasive but still comprehensive method of these parameters was the origin of Arteriograph idea. Using this device leads us to the extensive data report of what we need to perfectly decide about the further therapeutic interventions.


What is Pulse Wave Analysis (PWA)?

pulse wave analysis

Pulse Wave Analysis (PWA) is the morphological study of the pulse pressure waveform which provides comprehensive information about the state of ventricular ejection and the properties of the arterial tree such as arterial stiffness. In fact, it is a conciliatory approach to analyse parameters which are strong predictors of cardiovascular (CV) events especially in patients with high CV risk based on historical background and present status that lead to calculating the future potential of other complications such as symptomatic and asymptomatic atherosclerosis, hypertension, Premature aortic degeneration, heart failure and Diabetic mellitus as it’s consequence.

With the development of non-invasive techniques for the assessment of arterial stiffness easily obtainable by oscillometric technique, pulse wave velocity (PWV) and pulse wave analysis (PWA) of arterial wave-forms are widely used in population studies and clinical practices. 

A fundamental method for non-invasively studying arterial hemodynamic is central pulse wave analysis which evaluates arterial stiffness. This assessment also includes measurement of augmentation index which indicates endothelial function. Furthermore, central systolic blood pressure (SBPao) allows a better characterisation of the individual cardiovascular risk along other parameters to detect any possible vascular damages

In fact, due to proximity to the heart and the significant differences existing between the peripheral and central systolic arterial systems, central arterial pressure may be a better indicator for the quantification of cardiovascular risk and asymptomatic atherosclerosis. Even though brachial arterial pressure (bBP) still is assumed to play a distinguished role in the prediction of cardiovascular risk in clinical practice. 

On the other hand, augmentation index is related primarily to the endothelial function maintaining vascular tone of the arterioles and small arteries. In case of increased peripheral vascular resistance as a sign of vascular damage, the amplitude of reflected systolic wave increases which results in negative amount of AIx.


Arteriograph is the gold standard device for measuring Aortic Pulse Wave Velocity (PWVao), Central Systolic Blood Pressure (SBPao) and Aortic Augmentation Index (AIXao)

Aortic Pulse Wave Velocity (PWVao)

Aortic Pulse Wave Velocity (PWVao) is determined by the characteristics of the aortic wall. The stiffer the aortic wall, the faster the PWVao is. This parameter can indicate existence of asymptomatic atherosclerosis. 

Central Systolic Blood Pressure (SBPao)

Central Systolic Blood Pressure (SBPao) is related to vascular disease and its outcome stronger than traditional upper arm systolic blood pressure measurements. 

Augmentation Index (AIXao)

Aortic Augmentation Index (AIXao) is mainly determined by the peripheral arterial tone (resistance) of the small arteries and arterioles. It evaluates proper endothelial function and reveals probability of any vascular damage

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Facilitating the detection of atherosclerosis with Arteriograph

The name “Arteriosclerosis” refers to a group of conditions with the effect of arterial stiffening. Flexibility is a key characteristic of healthy arteries, as they carry oxygen and nutrients via blood to and from the heart and lungs. As the artery gradually stiffens, the blood flow becomes increasingly obstructed, causing circulation abnormalities.

Elevated blood pressure values, high cholesterol levels, and diabetes are factors that increase the risk of Arteriosclerosis development.

With a confusingly similar name, “Atherosclerosis” is a specific type of Arteriosclerosis. Atherosclerosis denotes a condition of plaque forming in the arteries, leading to their narrowing, and consequently, slower blood flow.

The development of Atherosclerosis starts at a young age. Scientific literature points to the possibility of teenagers already being affected. The symptoms are usually absent or unrecognizable except for middle-aged or older patients. At a certain point the severity of the artery obstruction causes pain. The rupturing of the blockages is also a possibility, causing blood to clot inside an artery at the site of the rupture.

At an age of 40, being apparently healthy generally, the risk of developing a severe level of Atherosclerosis during the patient’s remaining lifetime is 50%. This percentage increases – among other things – with age. The following factors (in addition to the above-mentioned Arteriosclerosis-related factors) also contribute to the development of Atherosclerosis:

  • Smoking
  • Lack of proper physical activity
  • Eating saturated fats
  • Obesity

Most adults older than 60 suffer a certain level of Atherosclerosis, but the symptoms for most of them are still unnoticeable.

Complications of Atherosclerosis include:

  • Aneurysms
  • Angina
  • Chronic kidney disease
  • Coronary or carotid heart disease
  • Heart attack
  • Heart failure
  • Peripheral artery disease
  • Stroke
  • Abnormal heart rhythms

 

How to diagnose Atherosclerosis noninvasively?

  • Ankle-brachial index (ABI)
  • IMT of the carotid arteries
  • Flow-mediated vasodilation (FMD)
  • Cardio-CT 
  • MR
  • Arterial function (stiffness) measurement

Arteriograph which is the best arterial function measurement, turned out to be one very promising and excellent method to reveal and to detect the asymptomatic Atherosclerosis.