Arteriograph & Cardiology
The CV risk assessment and the hypertension management are ones of the most common activities by the cardiologists. The measurement of arterial stiffness provides a strong and independent marker to reveal high CV risk even among those subjects, whose traditional risk factors based CV risk scores provide normal or only intermediate risk. It is a well known fact that there is a significant difference between the anti-hypertensive drugs concerning their lowering efficacy of central blood pressure and the arterial stiffness parameters’ values.
Arteriograph provides information about the risk of recurrent events in those patients, who have already suffered a myocardial infarction (MI). With Arteriograph we can monitor how effective the therapy is and it helps in finding the ideal, individual blood pressure lowering strategy.
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Scientific Publications
1. Oscillometrically Measured Aortic Pulse Wave Velocity Reveals Asymptomatic Carotid Atherosclerosis in a Middle-Aged, Apparently Healthy Population
This study hypothesised if there is an association between asymptomatic carotid atherosclerosis (ACA) and aortic pulse wave velocity (PWVao) in middle-aged, apparently healthy, normotensive population to reveal increased cardiovascular risk.
PWVao measured with the oscillometric method (Arteriograph) & ACA assessed by carotid artery ultrasonography. Result showed that ACA was present in 22% of cases. There is no difference between subjects with and without ACA in respect of gender, BMI, total cholesterol, or Heart Rate (HR). However, age, smoking, systolic blood pressure (SBP), and PWVao were higher in the ACA group compared to ACA negative subjects.
The most important finding of this study is that the Arteriograph is able to measure PWVao oscillometrically which proved to be an independent marker of ACA. The age in-dependency of PWVao measured by Arteriograph could deliver an important message since most of cardiovascular risk scores are age-driven.
Congestive Heart Failure (CHF)
1. The Prognostic Value of Arterial Stiffness in Systolic Heart Failure
Heart failure (HF) as a syndrome of ventricular dysfunction has a unacceptably high mortality rate. The study designed to follow up 98 patients with a diagnosis of heart failure in class III and IV based on New York Heart Association (NYHA) classification.
Since increased arterial stiffness seen an indicator of mortality, 18 month follow-up conducted for the patients suffering ischemic cardiomyopathy due to atherosclerotic heart disease by using Arteriograph. Out of 98 patients, 36 died and results proved augmentation index (AIx) and pulse wave velocity (PWV) are a strong predictor of mortality in advanced HF, independently of other prognostic variables. Therefore, measuring arterial stiffness parameters such as AIx & PWV non-invasivly could predict mortality in patients with advanced HF and help doctors to optimise their treatments.
2. Correlations between Vascular Stiffness Indicators, OPG, and 25-OH Vitamin D3 Status in Heart Failure Patients.
A strong predictor of mortality in Heart Failure is arterial stiffness together with renal vascular damage. Furthermore, in these patients very low levels of 25-OH-D3 have been detected along with high levels of OPG and high vascular calcification. This study is designed to find a correlation between biomarkers of vascular calcification (levels of OPG and Vitamin D3) with levels of arterial stiffness (measured by cfPWV using Arteriograph), Renal Resistive Index (RRI) and Left Ventricular Ejection Fraction (LVEF) in hear failure patients.
Results Showed significant low levels of VitD3 in Heart Failure patients compare to control which might contribute with elevated levels of arterial stiffness seen in these patients. Moreover, low levels of VitD3 indicate a close correlation with increased cardiac diameters and volumes, as well as decreased ejection fraction as well as increased RRI. The study also reported a strong negative correlation between OPG and LVEF.
This study demonstrated the importance of evaluation of VitD3 along with other important parameters such as renal function and vascular stiffness as indicators which play the key role in identifying patients with shorter life expectancy.
Coronary Artery Disease (CAD)
1. Arterial Stiffness is Increased in Families with Premature Coronary Artery Disease (CAD)
Considering the positive family history of premature coronary artery disease (CAD) as a risk factor for cardiovascular disease (CVD), this study discusses whether PWV is increased in first-degree relatives of patients with premature CAD or not.
Arterial stiffness was assessed using the Arteriograph system. Results showed increased in pulse wave velocity (PWV) both in patients with premature CAD as well as in first-degree relatives without CVD. This study concludes that independent of other risk factors, PWV is a reliable marker to evaluate arterial stiffness. This holds promise for the future, in which arterial stiffness might play a role in risk prediction within families with premature CAD.
2. Assessment of Pulse Wave Velocity and Augmentation Index in Different Arteries in Patients with Severe Coronary Heart Disease
Aortic PWV is an independent predictor of coronary heart disease and stroke in apparently healthy subjects. This study investigated if arterial wave reflection detects atherosclerosis of peripheral arteries in patients with documented coronary heart disease (CHD) using Augmentation Index. Moreover what is the correlation between PWV and atherosclerosis in different arteries in these subjects.
Coronary Artery Disease was confirmed in investigated subjects by coronary angiography. Aortic PWV and Augmentation Index were measured using the Arteriograph. PWV from upper and lower limbs were calculated using signals received from sensors attached to the limbs.
Results showed Aortic PWV and Aix were significantly increased in the CAD group compared with that in the control group but concerning peripheral pulse wave velocity only lower limb pulse wave velocity was significantly increased.
The strong association of aortic stiffness with atherosclerosis at various sites of the arterial tree suggests that aortic stiffness can be used as an indicator of generalised atherosclerosis. It is a simple, inexpensive and noninvasive means for studying changes in vascular system in patients with the coronary heart disease. Less significant correlation between peripheral arteries and CAD might be because these arteries under changes on the latest stages.
Cardiovascular (CV) Risk
1. Arterial Stiffness and Pulse Wave Reflection Are Increased in Patients Suffering from Severe Periodontitis
Based on strong correlation between oral inflammation and cardiovascular diseases, this study evaluates pulse wave velocity (PWV), augmentation index (AIx) and pulse pressure amplification (PPA) in patients with different stages of periodontitis compare to healthy controls.
Vascular examination conducted by following periodontal screening, using Arteriograph. Data evaluation revealed significantly higher PWV values and lower AIx for patients suffering from periodontitis.
Knowing that impaired vascular health is a common finding in patients suffering from severe periodontal disease, this study concludes that a concomitant routine cardiovascular evaluation maybe advised in case of sever periodonitis.
Autonomic Nervous System (ANS)
1. Correlations Between Aortic Stiffness and Parasympathetic Autonomic Function in Healthy Volunteers
several disorders such as diabetes mellitus (DM), hypertension and chronic kidney disease are result of cardiovascular autonomic dysfunction and vascular elasticity alterations. This study tried to figure out the relationship between pulse wave velocity (PWV), augmentation index (AIx), and cardiovascular autonomic function in healthy volunteers.
On the one hand, Echocardiographic assessments performed by using Toshiba PowerVision 8000 and Aplio ultrasound systems in order to measure Aortic strain, Aortic stiffness index, and Aortic distensibility. On the other hand, PWV and AIx were evaluated by Arteriograph. The results showed a quite close relationship between parasympathetic function and arterial stiffness even in healthy volunteers.
Hypertension
1. Role of Aortic Stiffness and Inflammation in the Etiology of Young-Onset Hypertension
This study aims to explore any meaningful correlations between Cytokines such as interleukin (IL)-6 and also MCP-1 and development of arterial hypertension. It also investigates their roles in the etiology of young-onset hypertension.
Pulse wave velocity (PWV) is detected as a marker of aortic stiffness measured by Arteriograph. The plasma levels of MCP-1 and IL-6 were determined using an enzyme-linked immunosorbent assay. The results showed positive correlation between PWV and the levels of MCP-1 and IL-6.
In conclusion, increased PWV and the levels of inflammatory markers were associated with aortic stiffness and inflammation in patients with young-onset hypertension, suggesting that these factors have a role in the etiology of hypertension.