What is an arterial pulse wave?
The pulse wave is a physiological phenomenon, observable and measurable in the arterial system during blood circulation. During one heart systole a certain blood volume is expelled. This propagates through the arteries due to the reciprocal transformation between kinetic energy of a segment of the expelled blood volume and the potential energy of a stretched segment of the resilient vascular wall. We can observe the changes in pressure, blood flow, velocity and profile throughout the whole pulse wave. It can be used for classification of the artery elasticity. evidence based click here
Why test for arterial elasticity?
"Aging and disease states associated with an increase in cardiovascular events alter the physical characteristics of blood vessel walls and impair the pulsatile function of the arteries. An accumulating body of evidence indicates that impaired pulsitile function of arteries provides important prognostic and therapeutic information beyond that provided by traditional blood pressure measurements."
"The ability to detect and monitor sub-clinical damage, representing the cumulative and integrated influence of risk factors in impairing arterial wall integrity, holds potential to further refine cardiovascular risk stratification and enable early intervention to prevent or attenuate disease progression."
"Accumulating evidence suggest that abnormalities in the pulsatile characteristics of arteries occur early in the disease processes associated with increased cardiovascular risk, and can be favorably modified by therapeutic interventions."
"We now know that the health of the endothelium and the blood vessels directly affects overall cardiovascular health. Cardiovascular disease kills 500,000 Americans every year in the form of heart attack and stroke. About 16 million more Americans suffer pain and disabilities caused by cardiovascular disease. Today, over 60,800,000 Americans (a quarter of the U.S. population) have one or more conditions that put them at risk for heart attack and stroke."
"The economic costs of these vessel diseases are staggering. In 2001, the economic cost of all cardiovascular disease was approximately $298 billion, including health expenditures and lost productivity". 10 ways to benefit your practice.
Waveforms Produced By The DPA
Plethysmogram (PTG) Waveform - The shape of the pulse wave is determined, in part, by the elasticity of the blood vessels. The DPA can analyze the shape of the curve to get early information about a developing arterial vascular disease. The pulse wave analysis can often detect changes very early, and is non-invasive, very easy to use, and one of the most economical techniques available today. The DPA uses a fingertip probe sensor - light from the LED/Photodiode is transmitted through the tissue at the sensor site. The Photodiode detects the changes in the amount of light absorbed by the hemoglobin which forms the PTG.
Accelerated Plethysmogram (APG) Waveform - The second derivative of PTG - an excellent method to evaluate the biological age of arteries.
Other Measurements With The DPA
- Pulse Rate
- Ejection time (Etc)
- Pulse Height (PH) - Pulse amplitude
- Ejection Elastic Index (EEI)-- indicator of Left Ventricle ejection and elasticity of large arteries
- Dicrotic Dilation Index (DDI)- indicator of small artery compliance
- Dicrotic Elastic Index (DEI) - peripheral vessel elasticity (arterioles to veins)
- Software program to measure Heart Rate Variability (HRV)
- Software program will store all patient information
- Early detection of arterial wall elasticity and determination of biological arterial age in less than 3 minutes
- Software program tests Heart Rate Variability (HRV) in 5 minutes
- Monitors effectiveness of therapeutic intervention
- Monitors arterial wall response to lifestyles changes / reduction of cardiovascular risk factors
- Non-invasive - uses a LED/Photodiode finger probe sensor.
- Device is FDA approved
- Lightweight and portable (12 lbs)
- User friendly
- Can be used alone (thermal printer) or interfaced with computer for storage of information
- Color printout data sheet when interfaced with user's computer/printer
- Revenue generator
Digital Pulse Analyzer (DPA) - Heart Rate Variability
The DPA now has an added software feature that measures Heart Rate Variability. Decreased HRV implies decreased ability to respond to changes in the environment. Too much consistency in heart rate (less variability) is often associated with dysfunction and disease. The DPA software analyzes imperceptible changes in the heart rate waveforms, provides indices and evaluates the current body condition and activities/balances of the autonomic nervous system.
Low HRV has been shown in numerous longitudinal studies to be related to a higher mortality rate in both healthy and unhealthy subjects. It thus can be shown to be a strong predicator of all-cause mortality. The heart is not just a simple pump, but a complex sensory organ with its own functional "heart brain" that communicates with and influences the brain via the nervous system, hormonal system and other pathways.
Research has shown that these influences profoundly affect brain function and most of the body's major organs. Science now confirms that stress significantly increases the risk of heart disease, including sudden cardiac death. Unmanaged emotional stress is equally if not more important than physical variables in determining health outcomes. A conservative estimate is that 75% of visits to primary care physicians are due to stress-related disorders.
Cardiovascular-related issues are not the only uses for the DPA. Psychologists are increasingly recognizing the importance of HRV. A number of studies have demonstrated that patients with anxiety, phobias and post-traumatic stress disorder (PSTD) consistently show lower HRV, even when not exposed to a trauma related prompt. Importantly, this relationship existed independent of age, gender, trait anxiety, cardio-respiratory fitness, heart rate, blood pressure and respiration rate.
The advantages of offering DPA in your practice. click here How does this compare to lifeline screening.