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2023年4月30日日曜日
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2023年4月21日金曜日
#野口悠紀雄氏【後編３】「 #デジタル経済の国際競争で勝ち残るには？」2021年11月18日（木）放送分 日経CNBC「GINZA CROSSING ...
#野口悠紀雄氏【後編２】「 #デジタル経済の国際競争で勝ち残るには？」2021年11月18日（木）放送分 日経CNBC「GINZA CROSING T...
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2023年4月7日金曜日
#Arteriograph が世紀の発明品だとの評価でる、#欧州最大手製薬会社が指定機器と発表、#小型_３分間計測_ワイヤレス_市販電池_ネット対応_低価格_メディカルテクニカ
Arteriograph- Comprehensive cardiovascular risk assessment in only 3 minutes! - A medical breakthrough in early diagnostics of atherosclerosis!
A big problem today is that many individuals with high risk of cardiovascular diseases otherwise have normal values; normal blood pressure, blood lipids and resting-EKG. The catastrophe strikes without any prior warning. The Arteriograph is an evidence based, fast, easy, noninvasive and user independent way of assessing cardiovascular risk. For the first time one have a good chance of finding high risk patient before it is too late.
⦁ Screening of early atherosclerosis among ”healthy” individuals. Only the Arteriograph is useful for this. The Arteriograph gives an overall picture of the risk of assessing cardiovascular disease.
⦁ Evaluating the effects of treatments (drugs, nutritional supplements and lifestyle changes etc) on the vascular functions among patients with established atherosclerosis (CAD, POST MI, STROKE, PAD)
⦁ Is it not enough to check the blood lipids and blood pressure to prevent atherosclerosis and thereby strokes? No, 40-60% of patients with stroke or heart attacks do not have any know abnormal values such as high amount of blood lipids or high blood pressure (Johns Hopkins White Papers, Coronary Heart Disease - 1998, etc). They also have normal blood glucose values, resting-EKG, are non-smokers and have a healthy diet. Up until now it has been impossible to find there individuals.
⦁ Todays metods of assessing cardiovascular risk (SCORE, Framingham) all have limits. They do not take into account important factors such as lack of physical activity, overweight, psychological factors or previous cardiovascular circumstances. (Simon, A. and Levenson, J.: May subclinical arterial disease helps to better detect and treat high-risk asymptomatic individuals? J Hypertension 2005, 23: 1939-1945)
⦁ In most cases, lowering the blood pressure is not enough to avoid early death. Individuals who can lower both their arterial stiffness and blood pressure have a much greater chance of a longer life.Circulation 2001;103:987
⦁ The Arteriograph is mobile and easy to use. The screening is fast, comfortable, harmless and user independent. It takes only a few minutes and can be described as a computerized blood pressure measurement.
⦁ Today´s other available methods are hard to use, expensive, and requires an adequate educated staff. In the future, the Arteriograph may replace the regular blood pressure measurement as it is just as easy but gives much more information.
The Arteriograph is intended for DAILY USE at your clinic to measure AIx, PWV and Central blood pressure etc.
Arteriograph- Comprehensive cardiovascular risk assessment in only 3 minutes!
- A medical breakthrough in early diagnostics of atherosclerosis!
A big problem today is that many individuals with high risk of cardiovascular diseases otherwise have normal values; normal blood pressure, blood lipids and resting-EKG. The catastrophe strikes without any prior warning.
The Arteriograph is an evidence based, fast, easy, noninvasive and user independent way of assessing cardiovascular risk. For the first time one have a good chance of finding high risk patients before it is too late .The Arteriograph is also used to evaluate the effect of different medications.
#Arteriograph_ハンガリ発明品が、#突然死_心不全_脳卒中などの危険因子を予測できる能力があると検証された
Statistics indicate that around 60% of the time in heart attack cases, a standard cholesterol or blood pressure test won’t have revealed anything out of the ordinary. Guidelines (published in 2007) from the European Society of Hypertension recommend measuring arterial stiffness in patients with arterial hypertension (high blood pressure).
Gordons Chemists are pleased to offer across Northern Ireland a cardiovascular screening clinic, using a state-of-the-art arteriograph. CardioHealth NI is the first and only company in Northern Ireland that uses an arteriograph; a session with CardioHealth NI at one of our cardiovascular screening clinics is priced at only £50.
A cardiovascular screening using an arteriograph reveals much more than a typical blood pressure or cholesterol test will. By offering this cardiovascular screening clinic, we allow the patient to have a better understanding of the health of their arteries. As such they can make the decision to take control of their cardiovascular health – hopefully reducing the incidence or severity of heart attack, stroke or high blood pressure.
In addition to identifying underlying health problems, the screening includes recommendations on diet and natural health solutions. A detailed report allows the patient to consult with their GP or medical professional in order to seek further advice and treatment, based on the findings of the screening.
The cardiovascular screening clinic is suitable for anyone aged 16 years and over, or anyone with a family history of heart disease, kidney disease or diabetes. It’s also suitable for anyone who drinks alcohol or smokes, is overweight, or participates in (or is returning to) a sport.
About the Arteriograph
An arteriograph is a sophisticated instrument used for detecting changes to the artery walls. The arteriograph uses a cuff that contains special pressure sensors.
These pressure sensors are designed to detect the Pulse Wave (pressure wave) that leaves the heart as it contracts. When the pulse wave reaches the end of the arterial system, it is then reflected back towards the heart. Three key measurements are taken from this pulse wave.
An arteriograph reveals damage to the heart and arteries that a standard blood pressure or cholesterol test will not. It measures parameters that indicate if the patient might at risk of heart attack or stroke, including:
Central Systolic Blood Pressure
This in effect measures blood pressure, at the heart. Studies indicate that this is of greater value than measuring blood pressure on the arm.
Brachial Augmentation
This reveals early damage to, and clogging up of, your smaller arteries. When arterial clogging begins, it occurs firstly in the small arteries of the hands and feet. This can be measured and it indicates the degree of clogging and the damage to the inner lining of your smaller arteries.
Pulse Wave Velocity
The speed of the pressure wave described above is measured over a given distance. An increased speed indicates a clogging of the arteries. There is a direct correlation between this, and an increased risk of heart attack/stroke. The reading is often found to be abnormal in patients with kidney disease, diabetes, sufferers of rheumatoid arthritis, and smokers.
The Arteriograph is a new, easy-to-use, and time-effective method for assessing arterial stiffness. Prior to the arteriograph, there were (and still are) two invasive methods used within a hospital setting: the tonometric and piezo-electronic systems (SphygmoCor and Complior).
An arteriograph is not intended as a replacement for these. Instead, the device is intended for use as a quick, affordable and non-invasive means of diagnosing an underlying condition that the patient may not be aware of. Clinical trials (see below for details) reveal that an arteriograph gives accurate results (which are comparable to the two systems mentioned).
The main advantage of using an arteriograph is that it offers a quick and affordable assessment, using only the upper arm.
Other methods involve a detailed examination and take time to complete. Typically, these (due to the time and expense involved in completing a screening) aren’t readily available at the request of a patient.
CardioHealth NI’s cardiovascular screening clinics offer the patient the opportunity to have a detailed and accurate assessment of their cardiovascular system completed – at a relatively low price, in a location close to them, in just half an hour.
Upcoming clinic detail can be obtained by emailing: info@gordonsdirect.com
Clinical Evidence
Publications on the validation of the Arteriograph device:
Baulmann, J. et al.
"A new oscillometric method for assessment of arterial stiffness: comparison with tonometric and piezo-electronic methods"
J Hypertens 2008, 26:523-528
http://www.arteriograph.hu/downloads/pdf/Baulmann%20validation-J-Hypert%2708March-Cover.pdf
#Arteriograph の素晴らしい役目ー #突然死_脳中_心不全などを予測できる発明品
The Scientific World Journal
Volume 2013 (2013), Article ID 792693, 6 pages
http://dx.doi.org/10.1155/2013/792693
Clinical Study
Evaluation of Arterial Stiffness for Predicting Future Cardiovascular Events in Patients with ST Segment Elevation and Non-ST Segment Elevation Myocardial Infarction
Oguz Akkus,1 Durmus Yildiray Sahin,2 Abdi Bozkurt,3 Kamil Nas,4 Kazım Serhan Ozcan,1 Miklós Illyés,5 Ferenc Molnár,6 Serafettin Demir,7 Mücahit Tüfenk,3 and Esmeray Acarturk3
1Sanliurfa Siverek State Hospital, 63600 Sanliurfa, Turkey
2Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey
3Department of Cardiology, Faculty of Medicine, Cukurova University, Adana, Turkey
4Department of Radiology, Szent János Hospital, Budapest, Hungary
5Heart Institute, Faculty of Medicine, University of Pécs, Pécs, Hungary
6Department of Hydrodynamic Systems, Budapest University of Technology and Economics, Budapest, Hungary
7Department of Cardiology, Adana State Hospital, Adana, Turkey
Received 18 August 2013; Accepted 15 September 2013
Academic Editors: H. Kitabata and E. Skalidis
Copyright © 2013 Oguz Akkus et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background. Arterial stiffness parameters in patients who experienced MACE after acute MI have not been studied sufficiently. We investigated arterial stiffness parameters in patients with ST segment elevation (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI). Methods. Ninety-four patients with acute MI (45 STEMI and 49 NSTEMI) were included in the study. Arterial stiffness was assessed noninvasively by using TensioMed Arteriograph. Results. Arterial stiffness parameters were found to be higher in NSTEMI group but did not achieve statistical significance apart from pulse pressure . There was no significant difference at MACE rates between two groups. Pulse pressure and heart rate were also significantly higher in MACE observed group. Aortic pulse wave velocity (PWV), aortic augmentation index (AI), systolic area index (SAI), heart rate, and pulse pressure were higher; ejection fraction, the return time (RT), diastolic reflex area (DRA), and diastolic area index (DAI) were significantly lower in patients with major cardiovascular events. However, PWV, heart rate, and ejection fraction were independent indicators at development of MACE. Conclusions. Parameters of arterial stiffness and MACE rates were similar in patients with STEMI and NSTEMI in one year followup. The independent prognostic indicator aortic PWV may be an easy and reliable method for determining the risk of future events in patients hospitalized with acute MI.
1. Introduction
Acute myocardial infarction (AMI) continues a worldwide cause of mortality [1]. In-hospital and 6-month-mortality are approximately 5–7% versus 12-13%, respectively [2, 3]. Estimated risk of mortality for AMI is based on the clinical status of the patients [4]. Recent studies showed that conventional risk factors are inadequate for predicting cardiovascular (CV) mortality and morbidity. A novel risk factor called arterial stiffness, which is a defined reduction of the compliance of arterial wall, and relationship between coronary heart disease (CHD) have been demonstrated. Arterial stiffness results in faster reflection of the forward pulse wave from bifurcation points in peripheral vessels. As a result of new waveform, systolic blood pressure (SBP) increases, diastolic blood pressure (DBP) decreases, cardiac workload increases, and coronary perfusion falls down. It plays a major role in the determination of cardiovascular outcomes, and it is not inferior to the traditional risk factors to assess the future risk [5, 6]. Elevated arterial stiffness is associated with increased major adverse cardiovascular events (MACE) such as unstable angina, AMI, coronary revascularization, heart failure, stroke, and death [7]. Arterial stiffness parameters including mean arterial pressure (MAP), pulse pressure (PP), PWV (m/s), and augmentation index (AI) are directly proportional to the risk of MACE [8–10].
PWV is a susceptible diagnostic element, and it is also involved in risk stratification for subclinical organ damages [11]. Few studies regarding arterial stiffness demonstrated that PWV exhibits a close effect with coronary heart disease [5, 12, 13]. Whether arterial stiffness parameters are related to MACE after acute MI has not been studied sufficiently. The aim of our study was to compare arterial stiffness parameters in patients with ST segment elevation (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI) and to validate its prognostic value.
2. Patients
Ninety-four patients with acute MI (72 men and 22 women, mean age 60,41 ± 11,17) were included in the study. There were 45 STEMI and 49 NSTEMI. Data of patients were analyzed within 24 hours after hospitalization. All patients received eligible treatment according to ESC guidelines. The choice of preparations was entrusted to the investigator. Hemodynamically compromised patients (Killip classifications II, III, and IV), patients with chronic atrial fibrillation and/or flutter, chronic renal failure, mild-severe valvular heart diseases and other chronic diseases were excluded. Our local ethics committee approved the study, and written informed consent was obtained from all participants. Patients were followed up for 12 months.
#Arteriograph_心不全_突然死_脳卒中などの予診の検証が #正確で3分間で結果が得られる世紀の発明との評価が多く報告されてきた
HypertensionVolume 77, Issue 2, February 2021; Pages 571-581
https://doi.org/10.1161/HYPERTENSIONAHA.120.15336
ATERIAL STIFFNESS
Aortic Pulse Wave Velocity Predicts Cardiovascular Events and
Mortality in Patients Undergoing Coronary Angiography
A Comparison of Invasive Measurements and Noninvasive Estimates
Bernhard Hametner, Siegfried Wassertheurer, Christopher Clemens Mayer,
Kathrin Danninger, Ronald K. Binder, and Thomas Weber
ABSTRACTAortic pulse wave velocity (PWV) is directly related to arterial stiffness.
Different methods for the determination of PWV coexist.
The aim of this prospective study was to evaluate the prognostic value of
PWV in high-risk patients with suspected coronary artery disease
undergoing invasive angiography and to compare 3 different methods
for assessing PWV. In 1040 patients,
invasive PWV (iPWV) was measured during catheter pullback.
Additionally, PWV was estimated with a model incorporating age,
central systolic blood pressure, and
pulse waveform characteristics obtained
from noninvasive measurements (estimated PWV).
As a third method, PWV was calculated
with a formula solely based on age and blood pressure
(formula-based PWV). Survival analysis
was based on continuous PWV as well as using cutoff values.
After a median follow-up duration of 1565 days,
24% of the patients reached the combined end point
(cardiovascular events or mortality).
Cox proportional hazard ratios per 1 SD were 1.35 for iPWV, 1.37
for estimated PWV, and 1.28 for formula-based PWV (P<0.0001
for all 3 methods) in univariate analysis,
remaining statistically significant after comprehensive multivariable adjustments.
In a model including a modified risk score for coronary artery disease, iPWV
and estimated PWV remained borderline significant.
The net reclassification improvement was significant for iPWV (0.173),
formula-based PWV (0.181), and estimated PWV (0.230).
All 3 methods for the determination of PWV predicted cardiovascular events
and mortality in patients with suspected coronary artery disease.
This indicates that iPWV as well as both noninvasive estimation methods
are suitable for the assessment of arterial stiffness,
bearing in mind their individual characteristics.
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