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There are number of underlying determinants of cardiovascular diseases. These are reflection of the major forces driving social, economic, cultural changes, urbanisation and behavioural, based on general status of the patient such as age, gender, lifestyle, diet, and other metabolic complication. The others based on calculated or measured essential parameters of the cardiovascular system itself such as blood pressure, cardiac output, ejection fraction etc. To rule out the underlying cause for better diagnosis and prevention of further complications which without any doubt would have a huge impact on reducing the burden of the cost for individuals and health care system as well.
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.
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), augmentation index (AIx) and pulse wave analysis 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 (CSBP) 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.
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) is related to vascular disease and its outcome stronger than traditional upper arm systolic blood pressure measurements.
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