The arteriosclerosis detection system is a set of four instruments for detecting arterial function:
）； 1. Carotid central pressure waveform analysis ( PWA );
）； 2. Arterial pulse wave velocity ( PWV );
）； 3. Ankle brachial blood pressure index ( ABI );
）风险预测。 4. Cardiovascular disease ( CVD ) risk prediction.
Supporting software and related technical indicators, early blood vessel aging assessment application software and data information database, the system is an integrated innovative, non-invasive, multi-parameter arterial function test and evaluation device.
1. Carotid central pressure waveform analysis (PWA)
(1) What is central arterial pressure?
The so-called central arterial pressure refers to the blood pressure at the root of the aorta. Measurements are generally made using an invasive catheter method. This product uses the pulse wave analysis (PWA) to measure the central arterial pressure from the brachial artery blood pressure, carotid artery waveform, and elbow artery waveform.
(2) What is the significance of detecting central arterial pressure?
As the validation results of the ASCOT test show, the effect of central arterial pressure on blood pressure varies depending on the antihypertensive drug. The better the antihypertensive effect of central arterial pressure, the more effectively it can suppress the occurrence of cardiovascular events. Therefore, the detection of central arterial pressure is very useful in the evaluation of the efficacy and risk of hypertension treatment.
It has been confirmed that the aorta and upper arm arteries have significant differences in pressure wave morphology and amplitude, and the SBP of the two can reach 80mmHg under exercise. It is therefore important to correct this difference.
There is evidence that the relationship between CAP and its related indexes and cardiovascular risk intermediate indicators may be closer than traditional brachial blood pressure, and may be a better predictor of cardiovascular and cerebrovascular events, especially atherosclerosis, independent of brachial blood pressure. According to some research data, in younger people and those without significant atherosclerosis and atherosclerosis, the peripheral arterial pressure is significantly higher than the central arterial pressure; in patients with significant atherosclerosis and atherosclerosis, especially in older patients, The peripheral arterial pressure may be very close to the central arterial pressure, and even the latter may be higher than the former.
a. Central arterial pressure has a more direct impact on internal organ perfusion and pressure load than peripheral.
b. Studies show that central arterial pressure predicts cardiovascular events better than peripheral brachial pressure.
c. Peripheral and central blood pressure are different. There are over- and under-estimation factors, such as peripheral enlargement, certain drugs, and physical stimulation.
d. Analysis of the central arterial pressure waveform can be derived to reflect ventricular constriction and pulsatile hemodynamic indicators.
Carotid pressure waveform analysis includes pulsatile hemodynamic technical indicators such as central arterial pressure, wave reflection, blood pressure pulsatility, and endocardial vitality ratio. Reflect arterial function and ventricular-arterial coupling for clinical cardiovascular disease assessment. Provide information parameters for risk stratification, evaluation of curative effect and early detection and prevention of vascular disease in patients with hypertension.
(3) The normal range of non-invasive CASP in normal people:
Normal non-invasive CASP has a linear relationship with gender and age.Especially when age and gender are considered at the same time, its correlation with non-invasive CASP is more significant.Every 10 years of age increase, non-invasive CASP increases by about 1.9 mmHg. About 2.5 mmHg in women.
The range of non-invasive CASP in normal people is 91.60 ～ 132.04 mmHg for males and 81.72 ～ 131.59 mmHg for females.
The level of noninvasive CASP is lower than that of brachial artery systolic blood pressure (SBP), but the brachial artery SBP-noninvasive CASP difference is independent of age and does not change with age.
(4) Increase Index (AI)
a. Explanation of terms:
When the pressure wave is conducted forward along the artery wall to the outer periphery, wave reflections are generated at blood vessels (usually resistance arterioles) with significantly different tissue structures ; the reflected waves are reversely conducted to the proximal artery at the same speed. Reverse conduction and forward conduction pressure waves will overlap. The position where the wave reflection occurs is called the inflection point (Pi). Generally, the peripheral arteries are about 80 cm from the heart. When the pressure wave velocity is normal, the adult reflex wave and the forward pressure wave overlap during the systole, while children usually overlap during the diastole. If the PWV increases or the peripheral arterial resistance increases and the reflex point advances, the overlap can occur early in the contraction.
The calculation formula for the increase index is AI = ΔP / PP. There are two main points in the previous literature on the specific interpretation of this formula. First, ΔP is the difference between the highest point blood pressure and the inflection point blood pressure (ie, reflected wave boosting), and PP is the pulse pressure difference (ie, the difference between systolic and diastolic blood pressure) ; second, application In the vascular echo tracking (eTRACKING, ET) technology, ΔP is the difference between the highest point of the systolic pressure wave and the coincident position of the outward pulse wave and the inverted reflex wave, and PP is the amplitude of the entire pulse wave. Xiao Husheng and others thought that the second description of ET for AI was reasonable.
b. Clinical significance:
The worse the compliance of blood vessels, the faster the reflection wave reflexes, the farther the position where the outward pulse wave and the reverse reflection wave coincide, the farther away from the systolic pressure wave apex, that is, the larger the ΔP; meanwhile, the blood vessel elasticity decreases, and the amplitude of the entire pulse wave decreases Small, so PP value decreases, so AI increases. Therefore, AI can quantitatively reflect the overall elasticity of the entire arterial system, and sensitively display changes in pressure wave reflection conditions and vessel diameter caused by changes in the elasticity of the large and small arteries. With its special value reflecting arterial elasticity, AI is widely used in clinical research in various fields.
2. Arterial pulse wave velocity (PWV)
1. Arterial pulse wave velocity (PWV)
(1) Pulse wave velocity of PWV (Pules Wave Velocity):
PWV calculation formula and clinical criteria:
Δt ） PWV = distance / time difference ( Δt )
动脉系统弹性减退是多种心血管危险因素对血管壁早期损害的综合反应，它不仅是血管病变早期具有特异性和敏感性的标志，而且也是一种高危因素，参与了心血管疾病的发生和发展，因此对动脉系统弹性功能的无创检测正在成为一个研究热点。 (2) Clinical significance: Decreased elasticity of the arterial system is a comprehensive response of multiple cardiovascular risk factors to early damage to the vascular wall. It is not only a sign of specificity and sensitivity in the early stages of vascular disease, but also a high-risk factor. The occurrence and development of cardiovascular disease, so non-invasive detection of the elastic function of the arterial system is becoming a research hotspot. Among them, pulse wave velocity (PWV) measurement is one of the commonly used non-invasive arterial elastic function detection indicators. As a non-invasive examination method, PWV can detect abnormalities of arterial function at an early stage, and comprehensively reflect the damage to blood vessels by various risk factors. Increased PWV is an independent risk factor for cardiovascular events and provides a reliable indicator for evaluating the effectiveness of clinical interventions.
(3) The range of normal and abnormal values of PWV:
The value of PWV will increase with age, and its reference value is 1400 cm / s.
According to the American College of Cardiology Medical / Scientific Report (1993):
a. PWV <1400cm / s: The arteriosclerosis is normal.
b. 1400cm / s <= PWV <= 1800cm / s: It is mild sclerosis of peripheral arteries.
3. Ankle brachial blood pressure index (ABI)
ABI可以无创伤地评估下肢动脉血管的开放情况，并可预测各种心脑血管事件的发生和死亡，它比单一用PWV来衡量动脉硬化更具准确，更具有客观性。 Clinical significance: ABI can evaluate the openness of arterial blood vessels in the lower extremity, and predict the occurrence and death of various cardiovascular and cerebrovascular events. It is more accurate and objective than measuring PWV alone. This is because if the arteries are highly narrowed or occluded, the pulse wave is blocked at the occluded site, and the collaterals have to be taken, so the propagation of the pulse wave will slow down. At this time, regardless of the progress of arteriosclerosis, sometimes PWV always displays normal or low values, which is likely to mislead the diagnosis of the disease. The ABI will be significantly reduced. From the value of ABI, we can find that the lower limb arteries are occluded. Therefore, the ABI index can be used as a complement to PWV, and the prediction of arteriosclerosis is more comprehensive.
Normal abnormal value: Under normal circumstances, ABI≥1, if ABI <1, it usually indicates that there is stenosis and occlusive disease in the lower limb arteries; if ABI <0.5, it means that the lower limb is severely ischemic, and if necessary, the lower limb blood supply should be reconstructed in time.
ABI normal range: 0.9 ~ 1.4
） Peripheral arteries of the lower limbs are at risk of sclerosis or narrowing of the diameter, peripheral vascular disease ( PAD )
） Peripheral arteries of the lower limbs are at high risk of sclerosis or narrowed diameter, and peripheral vascular disease ( PAD )
） Part of the peripheral arteries of the lower limbs may have been completely blocked, peripheral vascular disease ( PAD )
） Peripheral arteries of the lower limb may have been completely obstructed in many places, and peripheral vascular disease ( PAD )
Lower limb vascular calcification
4. Prediction of additional cardiovascular disease (CVD) risks
(1) Reclassification of cardiovascular risk
Cardiovascular risk was reclassified according to the FRS model scoring stratification, combined with subclinical vascular disease technical indicators.
a. Any of PWVa-f, AI, and ABI reaching the subclinical vascular lesion threshold level is high risk (+).
b. FRS score> 20 is classified as high risk (+);
<20 points, including low-risk and intermediate-risk vascular age, need to be reclassified based on the degree of vascular disease (see Table 1).
Table 1 Cardiovascular risk reclassification
Vascular disease assessment index
FRS Score, Vascular Age, Years
Low risk (%) Medium risk (%) High risk (%)
PWVa-f = m / s
(2) Clinical application
(A) Healthy people or community people need further cardiovascular risk stratification, early assessment of vascular aging, and screening of high-risk populations after general physical examination, to provide a basis for decision-making on comprehensive prevention and individualization, and ultimately to delay or reverse early vascular aging;
(B) Early judgment of vascular aging-related diseases (hypertension, atherosclerosis, metabolic syndrome, diabetes and chronic kidney disease), decision-making treatment, prediction of prognosis and efficacy evaluation;
(C) Provide sub-clinical vascular disease monitoring and intermediate endpoint assessment indicators for rehabilitation and clinical research;
(D) Provide vascular disease monitoring, risk assessment and individualized prevention and treatment for cardiovascular health care and rehabilitation of people with special needs, with a view to delaying early vascular aging;
型 动脉硬化检测系统配置单 BX-5100B type arteriosclerosis detection system configuration sheet
Keyboard and mouse
With mouse pad
4 HK-2000B sensors
1 sensor with handle
Blood pressure cuff
Fresh chapter valid copy invalid
Certificate of conformity
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