• The scope of the Arteriograph:1. Screening asymptomatic,
apparently healthy subjects• It makes possible to detect
atherosclerosis in an early phase
2. Evaluating the efficiency of applied therapy• Follow-up• Comparison
The data show low risk – the subject is presumed to be healthy, no intervention
is needed (according to guidelines) !!!
However, according to arterial stiffness evaluation with Arteriograph...
Elevated Aix = risk of endothel disfunction !!!
• Examination:– High cholesterol level (7,30 mmol/l)
was determined
• Conclusion:– By screening a low-risk, apparently
healthy subject with Arteriograph risk of endothel disfunction could be showed
– Therefore the screening of asymptomatic subject with Arteriograph is needed and important !!!
However according to arterial stiffness evaluation with Arteriograph...
Elevated PWV (>9,62) = high CV risk !!!
According to ESH / ESC guidelines intervention is needed !!!
Enalapril, Hydrochlorothiazide
Low CV risk, according to SCORE stratification, no intervention is needed
• Examination:– Carotid Ultrasound – positive
(plaque)
• Conclusion:– By screening an apparently healthy
subject with Arteriograph high CV risk could be showed
– Further examination (CUS) confirmed the necessity of treatment
Bisoprolol, Ramipril
Abnormal Aix, high central blood pressure
(Increased peripheral vasoconstriction!)
First example
Use a β-blocker, with vasodilation effect !!!
However…
Treated (β-blocker) hypertensive subject
Quinapril, Nebivolol, Atorvastatin, Acetylsalicylic Acid
First example
β-blocker with vasodilation effect
Normal Aix, normal central blood pressure !!!
The same subject with modified therapy
Bisoprolol, SimvastatinTreated (β-blocker) hypertensive subject
Abnormal Aix, high central blood pressure
(Increased peripheral vasoconstriction!)
What are we supposed to do???
Rethink the treatment!!! (Change therapy!)
Second example
Amlodipine, SimvastatinThe suggested new medicine is a CCB
Normal Aix, improved central systolic blood pressure !!!
Second example
• Conclusion:– When treating a hypertensive
subject, it is very important to lower - besides the peripheral BP - the central blood pressure as well !!!
– The Arteriograph gives important hemodynamical parameters by which the effect of an anti-hypertensive drug can be evaluated