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2014-06-05 06:06:58

TensioMed Arteriograph

テーマ:医療機器

28th Annual Scientific Meeting and Exposition, San Francisco, USA May 15-18, 2013

The Journal of Clinical Hypertension, 2013, Volume 15,
May 2013 Abstract Supplement

28th Annual Scientific Meeting and Exposition
San Francisco, USA May 15-18, 2013.


Acute Coronary Syndrome Patients: How Stiff are their Arteries?

Deaconu Alexandru Ioan 1 , Tautu Oana Florentina 1 , Fruntelata Ana Gabriela 2 , Dorobantu Maria 1

1 Emergency Hospital of Bucharest, Bucharest, Romania;
2 Monza Cardiovascular Center, Bucharest, Romania

Several non-invasive methods are currently used to assess vascular stiffness. Pulse wave velocity (PWV) and the augmentation index (AIx) are the two major non-invasive methods of assessing arterial stiffness. A large amount of evidence indicates that carotid-femoral PWV is an intermediate endpoint for cardiovascular (CV) events, either fatal or non-fatal. Central AIx and pulse pressure have shown an independent predictive value for CV events in hypertensives and patients with coronary disease. Studies of arterial stiffness in patients with cardiovascular emergencies and acute coronary syndromes, respectively, are missing.

We performed measurements of arterial stiffness parameters using the TensioMed Arteriograph in 34 patients admitted for acute coronary syndromes (ACS), 24 hours after admission. The study group included 28 males (82.4%) and mean age was 61.7 ± 14.07 years. Arterial stiffness parameters as aortic PWV, aortic AIx, central systolic blood pressure (aortic SBP), central pulse pressure (aortic PP) were analyzed in relation to clinical, historical and paraclinical parameters in order to describe particularities in this patient population. We compared the results with an age and sex adjusted population of 34 controls randomly selected from the most recent Romanian cross-populational statistical survey, SEPHAR II.

In our group, 45.7% of patients were hypertensive and 37.1% were diabetic. Most of the patients were on treatment with ACE inhibitors (91.4%) and beta-blockers (80%), while 71.1% were on intravenous or oral nitrates. Mean stiffness parameters in this group were: aortic AIx=28.51 + 10.81, with only 14.8% of patients showing normal values; aortic PWV = 9.71 ± 1.82 m/s; aortic SBP = 121.71 ± 21.07 mm Hg; aortic PP = 44.39 ± 13.74 mm Hg. No correlations were identified in this small group between arterial stiffness parameters and treatment, history of hypertension or diabetes, type of ACS and angiographic coronary anatomy. While aortic AIx was clearly abnormal, reflecting changes in endothelial function and waves’ reflection, the other parameters of arterial stiffness were not different from other patient populations.

Aortic AIx is abnormally increased in patients with acute coronary syndromes. Parameters of arterial stiffness in patients with ACS are not related to treatment, type of coronary disease or previous patient history.

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2014-06-05 06:05:47

Arteriograph

テーマ:医療機器

Invasive Validation of Arteriograph Estimates of Central Blood Pressure in Patients With Type 2 Diabetes

1. Niklas Blach Rossen 1 ,2 ,

2. Esben Laugesen 2 ,

3. Christian Daugaard Peters 3 ,

4. Eva Ebbehøj 2 ,

5. Søren Tang Knudsen 2 ,

6. Per Løgstrup Poulsen 2 ,

7. Hans Erik Bøtker 4 and

8. Klavs Würgler Hansen 1

+ Author Affiliations

1. 1 Department of Medicine, Silkeborg Regional Hospital, Silkeborg, Denmark;

2. 2 Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark;

3. 3 Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark;

4. 4 Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.

1. Correspondence: Niklas Blach Rossen (niklas.rossen@rm.dk ).

* Received April 15, 2013.

* Revision received August 6, 2013.

* Accepted August 7, 2013.

Abstract

BACKGROUND Central blood pressure (BP) has attracted increasing interest because of a potential superiority over brachial BP in predicting cardiovascular morbidity and mortality. Several devices estimating central BP noninvasively are now available. The aim of our study was to determine the validity of the Arteriograph, a brachial cuff-based, oscillometric device, in patients with type 2 diabetes.

METHODS We measured central BP invasively and compared it with the Arteriograph-estimated values in 22 type 2 diabetic patients referred to elective coronary angiography.

RESULTS The difference (invasively measured BP minus Arteriograph-estimated BP) in central systolic BP (SBP) was 4.4±8.7mm Hg (P = 0.03). The limits of agreement were ±17.1mm Hg.

CONCLUSIONS Compared with invasively measured central SBP, we found a systematic underestimation by the Arteriograph. However, the limits of agreement were similar to the previous Arteriograph validation study and to the invasive validation studies of other brachial cuff-based, oscillometric devices. A limitation in our study was the large number of patients (n = 14 of 36) in which the Arteriograph was unable to analyze the pressure curves. In a research setting, the Arteriograph seems applicable in patients with type 2 diabetes.

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2014-06-05 06:04:37

Arteriograph (TensioMed, Budapest, Hungary

テーマ:医療機器

Hypertension Research (2011) 34, 202–208; doi:10.1038/hr.2010.196; published online 21 October 2010

Can arterial stiffness parameters be measured in the sitting position?

Jens Nürnberger1 , Rene Michalski2 , Tobias R Türk2 , Anabelle Opazo Saez1 , Oliver Witzke2 and Andreas Kribben2

1. 1Department of Nephrology and Dialysis, HELIOS Kliniken Schwerin, Wismarsche Straße, Schwerin, Germany

2. 2Department of Nephrology, University Hospital Essen, University Essen-Duisburg, Hufelandstraße, Essen, Germany

Correspondence: Dr J Nürnberger, Department of Nephrology, HELIOS Kliniken Schwerin, Wismarsche Straße 393-397, Schwerin 19049, Germany. E-mail: jens.nuernberger@uni-due.de

Received 2 May 2010; Revised 25 July 2010; Accepted 31 July 2010; Published online 21 October 2010.

Top of page

Abstract

Despite the introduction of arterial stiffness measurements in the European recommendation, pulse wave velocity (PWV) and augmentation index (AI) are still not used routinely in clinical practice. It would be of advantage if such measurements were done in the sitting position as is done for blood pressure. The aim of this study was to evaluate whether there is a difference in stiffness parameters in sitting vs. supine position. Arterial stiffness was measured in 24 healthy volunteers and 20 patients with cardiovascular disease using three different devices: SphygmoCor (Atcor Medical, Sydney, Australia), Arteriograph (TensioMed, Budapest, Hungary) and Vascular Explorer (Enverdis, Jena, Germany). Three measurements were performed in supine position followed by three measurements in sitting position. Methods were compared using correlation and Bland–Altman analysis. There was a significant correlation between PWV in supine and sitting position (Arteriograph: P<0.0001, r=0.93; Vascular Explorer; P<0.0001, r=0.87). There were significant correlations between AI sitting and AI supine using Arteriograph (P<0.0001, r=0.97), Vascular Explorer (P<0.0001, r=0.98) and SphygmoCor (P<0.0001, r=0.96). When analyzed by Bland–Altman, PWV and AI measurements in supine vs. sitting showed good agreement. There was no significant difference in PWV obtained with the three different devices (Arteriograph 7.5±1.6ms-1, Vascular Explorer 7.3±0.9ms-1, SphygmoCor 7.0±1.8ms-1). AI was significantly higher using the Arteriograph (17.6±15.0%) than Vascular Explorer and SphygmoCor (10.2±15.1% and 10.3±18.1%, respectively). The close agreement between sitting and supine measurements suggests that both PWV and AI can be reliably measured in the sitting position.

Keywords:

arterial stiffness; augmentation index; PWV; pluse wave velocity

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2014-06-05 06:01:58

TensioClinic Arteriograph

テーマ:医療機器

American Journal of Hypertension

ajh.oxfordjournals.org

Am J Hypertens (2005) 18 (S4): 15A. doi: 10.1016/j.amjhyper.2005.03.035

P-17: A new and fast screening method for measuring complex hemodynamical parameters and arterial stiffness non-invasively with a simple arm cuff

Miklos Illyes 1

+ Author Affiliations

1TensioMed Ltd., TensioMed Ltd, Budapest, Hungary

Abstract

Aims: In a project of the National Research Program of Hungary, we studied if oscillometric signals received during an oscillometric BP measurement contain any information about arterial hemodynamics

Materials, Methods: We have developed a research tool by which not only SBP, DBP, HR data, but the complete oscillometric signals were stored and transmitted telemedically to our computer center from the home of 650 patients who performed BP measurements at least 4 times a day, for at least 1 month. Through this a large database was collected, containing more than 1700000 oscillometric pulse curves and the relevant clinical data of patients. For data mining we used Kohonen's self-organising map method. Non-invasively recorded oscillometric curves from the upper arm cuff were validated by the simultaneously recorded intraarterial pressure curve of brachial artery.

Results: Our researches showed that oscillometric pulse curve of the brachial artery is identical to the intraarterial pressure curve if the cuff was inflated to suprasystolic pressure, preferably 35 mmHg above the SBP. Thus the early and the late systolic pressure peak, the closing incisure of the aortic valve can be recognizable, and several hemodinamical parameters could be calculated.

By using the mentioned results of basic researches, a new instrument, the TensioClinic Arteriograph was developed, by which the following parameters could be measured within 2 minutes, by using a simple upper arm cuff:

SBP, DBP, HR, MAP, PP, augmentation index (AIx), normalized augmentation index to 80/min heart rate (AIx80), return time of the pulse wave of the aorta (RT), pulse wave velocity (PWV) of the aorta, length of the cardiac cycle, area of systolic (SAI) and diastolic (DAI) part of pulse curve.

Validation studies of the new method to control the accuracy of measured AIx and PWV showed high correlations (R = 0,76 and R = 0,8) with values measured with other non-invasive methods (Sphygmocor and Complior) respectively.

Conclusions: Due to the swiftness, simplicity and good reproducibility of this method and apparatus, the non-invasive assessment of the most important hemodynamical parameters and arterial stiffness had become available for population screening, opening a new window in the detection of the early phase of the athero- and arteriosclerosis, and thus it can play an important role in the reduction of the CV morbidity and mortality.

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2014-06-05 05:59:01

the Arteriograph 24

テーマ:医療機器

The heart of the matter

Kathleen Armstrong looks at developments

in cardiac patient monitoring that are improving

both the diagnosis and treatment of cardiovascular disease (CVD).

The market for cardiac patient monitoring devices market is

growing, driven by unhealthy lifestyles, an ageing population,

and the consequent increase in cardiovascular disease (CVD).

But the main reason is growth in the demand for easy-to-use,

patient-friendly devices that enable rapid and

robust diagnoses of CVD, according to a recent report

from Frost & Sullivan1.

Robert Clark, general manager of Draeger UK,

says one of the major advances is the improvement in networking

and the delivery of information.

All of its patient monitoring devices are WiFi-enabled

so patients can be monitored from wherever there is WiFi access in the trust.

Draeger’s Infinity M300 is a telemetry device which is worn

by the patient and continues to communicate with a trust’s network

via the Infinity CentralStation wherever the patient is in the hospital.

It means the patient can continued to be monitored

when they go to the physiotherapist or for tests.

“This gives the patient more flexibility and, because it continues

to monitor them, it can catch the episode that you want to capture,”

Clark says. At Derriford Hospital in Plymouth,

where the trust uses Draeger’s Infinity Omega solution, patients are

equipped with the telemetry device for a 24-hour assessment.

Because the information has been gathered without a break and

is captured online, where it can be accessed by the cardiologist,

the patient no longer has to undergo a second session of monitoring

when they go to the cardiologist.

“Hospitals are now re-thinking their care processes,” Clark comments.

Unimedic’s Arteriograph is a groundbreaking technology

that has advanced the way cardiac monitoring is undertaken.

Using a non-invasive catherisation method

with the help of a single arm cuff, the Arteriograph takes two minutes

to measure individual cardiovascular risk and

evaluate the efficiency of applied therapy.

The device provides information on central and

peripheral blood pressure, endothelial function, arterial stiffness,

arterial/heart age and cardiac fitness at the same time,

showing the effects of cardiovascular risk factors on the arteries.

Unimedic’s Arteriograph measures individual cardiovascular risk

and evaluates the efficiency of applied therapy within two minutesIn mid-September the company also launched the Arteriograph 24,

an ambulatory device which will enable central blood pressure and

arterial stiffness to be monitored over a 24-hour period.

The device is the more-advanced version of

the most accurate (BHS AA validated) and best value

for money ambulatory blood pressure monitor on the market,

the TensioDay ABPM, which comes with a professional software package.

It is an idea solution for practices wanting to comply

with the recommendations of the new NICE Hypertension Guideline

for diagnosing high blood pressure.

TensioDay ABPM helps practices to comply with new NICE guidelines

for diagnosing high blood pressure 13 July 2011

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2014-06-05 05:57:25

TensioMed™ Arteriograph 24

テーマ:医療機器

Diurnal variation in blood pressure and arterial stiffness in CKD – the role of endothelin-1

Neeraj Dhaun, Rebecca Moorhouse, Iain M MacIntyre, Vanessa Melville,

Robert A Kimmitt, Kayleigh E Brown, Euan Kennedy, Jane Goddard, David J Webb

BHF Centre of Research Excellence, University of Edinburgh

Introduction

Hypertension and arterial stiffness are important independent cardiovascular risk factors in CKD to which endothelin-1 (ET-1) contributes. Whereas loss of nocturnal blood pressure (BP) dipping in CKD is associated with disease progression there are no data on diurnal variations in arterial stiffness. We examined the diurnal variation of BP, arterial stiffness and the ET system in CKD and the effects on these of ETA receptor antagonism.

Methods

First, in a case-control study we compared 24h ambulatory BP and arterial stiffness using the TensioMed™ Arteriograph 24 ambulatory arterial stiffness monitor in 16 patients with CKD and 15 matched controls. Second, in an observational study we examined the diurnal variation in plasma and urinary ET-1 (midday and midnight) in 15 patients with CKD. Third, in a randomised double-blind, 3-way crossover study in 27 patients with CKD, we examined the effects of 6 weeks’ treatment with placebo, sitaxentan (an ETA receptor antagonist), and nifedipine on the diurnal variation of BP assessed at baseline and week 6 of each study period. This was in addition to the primary endpoints of proteinuria, BP and arterial stiffness.

Results

There were nocturnal dips in systolic and diastolic BP (SBP, DBP) and pulse wave velocity (PWV), our measure of arterial stiffness, in 15 controls (SBP -3.2 ± 4.8%, p < 0.05; DBP -6.4 ± 6.2%, p = 0.001; PWV -5.8 ± 5.2%, p < 0.01), but not in 16 CKD patients. In 15 CKD patients, plasma ET-1 increased from 4.8 ± 1.5 at midday to 5.1 ± 1.5pg/ml at midnight (p < 0.01). Urinary ET-1 did not change. 6 weeks’ treatment with placebo and nifedipine did not affect nocturnal dips in SBP or DBP between baseline and week 6 whereas dipping was increased following 6 weeks’ sitaxentan treatment (baseline vs. week 6, SBP: -7.0 ± 6.2 vs. -11.0 ± 7.8mmHg, p < 0.05; DBP: -6.0 ± 3.6 vs. -8.3 ± 5.1mmHg, p < 0.05). There was no nocturnal dip in pulse pressure at baseline in the 3 phases of the study, whereas sitaxentan was linked to the development of a nocturnal dip in pulse pressure.

Conclusion

In CKD, activation of the ET system appears to contribute not only to raised BP, but also the loss of BP dipping. The clinical significance of these findings should be explored in future clinical trials.

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2014-06-05 05:56:04

24-h Arteriograph ® Central BP

テーマ:医療機器

Laboratory investigations (WP4): fasting plasma glucose, lipids, serum creatinine, serum

liver enzymes, biomarkers (for inflammation, copeptin, etc., see Table 1), urinary spot sample

for microalbuminuria and albumin/creatinine ratio. In addition, faeces samples will be

obtained for determination of secreted factors as well as a genetic screening for evaluation of

the gut bacterial content and composition (microbiota). A biobank will be established in

technical collaboration between Lund University and other partners (Region Skåne,

BBMRI.se). Assessment of leukocyte types and activation in whole blood will be performed

in representative subsets of subjects.

5. Metabolic investigation (WP5): including fasting blood sampling for plasma glucose and

serum lipids (total cholesterol: C, HDL-C, LDL-C and triglycerides, LpLA2, Lp(a), etc.), and

an oral glucose tolerance test (OGTT; 75 g glucose), with measurements at 0,30,(60) and 120

min of plasma glucose, incretins (GLP-1, GIP), insulin, C-peptide and glucagon.

6. Technical investigations (WP6): arterial stiffness (Sphygmocor ® assessment of pulse wave

velocity, augmentation index, central blood pressure), arteria carotis morphology and

function (Sekoya ® ultrasound device), 24-h ambulatory blood pressure recordings, and

central aortic pressure (24-h Arteriograph ® Central BP). We will perform screening

spirometry and evaluation of endothelial function (by EndoPat ®).Measurement of Advanced

Glycation End Products (AGE) will be conducted transdermally by use of an AGE-Reader®.

In addition, other investigations are optional and depending on funding, such as brain

magnetic resonance imaging (MRI) as well as echocardiography, and retinal artery imaging

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2014-06-05 05:33:32

血圧脈波検査装置

テーマ:医療機器

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2014-06-05 05:32:25

血圧脈波検査装置

テーマ:高血圧

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2014-06-05 05:30:14

安静時、負荷試験、集中治療室、ホルター心電図、自宅、海外すべて統合

テーマ:心電計

Labtech Video

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