Cardiovascular prevention
Arteriograph – measuring arterial stiffness
A fifteen-minute measurement that feels like having your blood pressure taken, but tells you far more: the state of your arteries and the arterial age of your vascular system.
Did you know that every second death in Slovakia is caused by cardiovascular disease? Heart attacks and strokes often arrive without warning, sometimes at a surprisingly young age. These events are frequently the final stage of a long-running process of atherosclerosis.
Few of us realise that the fatal complications of atherosclerosis are not inevitable. With early diagnosis and prevention, cardiovascular disease can be deliberately and effectively avoided.
Would you like to know the age of your arterial system? To assess the stiffness of your vessel walls, which points to impaired function of their lining – most often as a result of inflammation – and the resulting risk of advanced atherosclerosis and of a heart attack or stroke?
Who is the measurement for?
It is recommended for everyone over the age of 20, and particularly for those:
- who live and work under excessive stress
- who are overweight
- who smoke
- with diabetes or kidney disease
- with high blood pressure
- with a family history of hypertension, heart disease or diabetes
- with high cholesterol or triglyceride levels
- with any symptoms suggesting arterial disease
- women going through the menopause
What is an arteriograph?
The device records and evaluates pressure and pulse waves in the upper arm, much like a blood pressure measurement. This simple procedure gives precise information about the state of all the arteries. Automated evaluation lets us detect cardiovascular disease before serious health problems appear.
The method is based on recording signals that reflect the state of the whole vascular system, and it provides information about the elasticity of the arterial wall. How elastic that wall is relates closely to how far atherosclerotic changes have progressed.
What does the device measure, and how? The measurement itself resembles a simple blood pressure reading, but it can determine far more than systolic and diastolic pressure. A cuff placed on the upper arm detects complete pulse curves, which correspond to changes in blood pressure. The device converts these curves into an electronic signal, which is then analysed by computer.
The information obtained describes:
- the function of the small arteries, whose total surface area is the largest organ in the body,
- pressure conditions in the main artery (the aorta) close to the heart, and therefore the immediate load on the heart,
- the elasticity of the main artery – from average values for the Central European population it can calculate an individual’s arterial age.
Ideally, the arterial age determined this way is not the same as the person’s actual age. The method yields important information about the function of the cells in the vessel wall and about the elasticity of the aorta. The more elastic that wall, the healthier the aorta.
In practical terms this 15-minute measurement resembles taking blood pressure several times over. Twelve parameters are determined, among them values describing the state of both larger and smaller arteries. Conventional blood pressure measurement simply does not give enough information: even at lower pressure readings we are often faced with the consequences of atherosclerotic change and poor arterial function. The disease can begin in early childhood, when no one yet doubts their health.
What happens after the measurement?
You receive a printed report of the results, on the basis of which the doctor can decide on any further examinations and adjust treatment. The report shows parameters describing arterial elasticity: values assessing the general stress the arteries are under, the aortic pulse wave velocity, and the central aortic pressure, which describes pressure conditions close to the heart.
Of the methods currently available for diagnostic screening, assessing arterial health with an arteriograph is the simplest and most accessible. It reveals atherosclerotic changes, and susceptibility to them, at the earliest stage. The greatest advantage of the method is that it can do so while the patient is still asymptomatic, when there is still a chance of prevention and early treatment.
The values given in the report
PWVao – Aortic pulse wave velocity Aortic Pulse Wave Velocity
Describes how fast the pressure wave generated by the heart travels from the aortic arch to the bifurcation. It characterises the elasticity of the aortic wall. According to the guidelines of the European societies of hypertension and cardiology, an elevated value on its own represents high cardiovascular risk and target organ damage. The parameter is calculated from the ratio between the distance from the jugular notch to the pubic symphysis (which corresponds to the length of the aorta) and the time needed to cover that distance.
Aix brachial – Augmentation index Augmentation Index
The augmentation index reflects the distensibility of the small vessels (arterioles) and the reflectivity of the peripheral vascular system. The pressure-pulse curve is a summation wave with a complex structure. Its systolic section consists of a forward-travelling wave generated by ejection from the left ventricle and a later peak arising from its reflection from the periphery. The augmentation index describes the relationship between these two peaks: an increase in peripheral vascular resistance from any cause raises the amplitude of the second component of the pulse wave.
SBPao – Central aortic pressure Systolic Blood Pressure in the Aorta
Reflects pressure conditions at the aortic root; the central aortic pressure differs from the peripheral pressure measured at the upper arm. It has greater predictive value for cardiovascular risk than peripheral blood pressure. The calculation is based on the diastolic pressure, the mean arterial pressure and the physiological relationship between peripheral and central pressure.
Ppao – Central pulse pressure Central Pulse Pressure
The difference between systolic and diastolic blood pressure. Just as the systolic central pressure differs from the systolic peripheral pressure, the pulse pressure at the aortic root can differ from the peripheral pulse pressure. It is an independent predictor of cardiovascular risk.
ED – Ejection duration Ejection Duration
The length of mechanical systole, the period between the opening and closing of the aortic valve.
DRA – Diastolic reflection area Diastolic Reflexion Area
Describes the pressure conditions filling the coronary arteries during diastole. It takes into account the length of diastole, the theoretical curve without wave reflection, and the actual pressure curve. It indicates the extent to which the pressure present during diastole contributes to filling the coronary arteries.
SAI – Systolic area index Systolic Area Index
The portion of the cardiac cycle curve falling within systole.
DAI – Diastolic area index Diastolic Area Index
The portion of the cardiac cycle curve falling within diastole. The higher the DAI, the better the perfusion of the coronary arteries.
SD – Quality control Standard deviation
A parameter reflecting the quality of the measurement. It is the variance of the PWVao values of the cardiac cycles measured in the suprasystolic range. Above 1.1 m/s an alarm appears on the display in red — it identifies pulse curves distorted by interference (movement, arrhythmia, breathing), and the measurement should be repeated.
RT – Return time Return time
Describes the time taken by the pressure wave generated by the heart to travel from the aortic arch to the bifurcation and back.