Technical innovations for early cardiovascular diagnostic

Examine non-invasive, easy and cost-effective!

In order to avoid severe secondary damage and an increased mortality in humans with cardovascular risk, the stratification of its risk and the early detection of pathologic changes is of major importance for an exact therapeutic strategy.

With the CARDIOLOGIC EXPLORER and VASCULAR EXPLORER enverdis GmbH Jena presented new patient-minded and user-friendly tools for the early cardiovascular diagnostic as well as first practical experience.

enverdis has committed itself to supply doctors and assistant physicians with uncomplicated diagnostic tools, with the result that this young company, based in Jena, Germany, produces innovative products, which enable a stress-free and non-invasive early diagnostic for patients, as well as a meaningful control and risk-screening of arteriosclerosical as well as diabetic diseases of heart and vascular system.

Stress-free CAD diagnosis with cardiogoniometry (CGM)

Coronary heart disease due to arteriosclerosis as well as Small Vessel Disease (SMD) due to diabetis are the main reasons for myocardic ischemia. According to Prof. Dr. Rainer Wessely, Duisburg, an exact and early diagnosis of CAD is absolutely relevant to prevent complications. With a diagnosis in time one can prevent the often- cited after effect infarction or chronic heart failure, thus the most frequent cause of death. This applies mainly to high risk patients like the large group of those with known CAD/myocardic infarction, chronic renal failure, diabetis m. and with inherited dyslipidemia. However, in order to guarantee a sufficiently high sensitivity and specifity of early cardiac diagnostic, ECG and stress ECG are not ideal methods, said Prof. Wessely. For early diagnosis of CAD the enverdis CARDIOLOGIC EXPLORER offers a 3-dimensional ECG via cardiogoniometry by Sanz (CGM),which show sterical structures of the electric potentials of the heart in depolarization and repolarization. Thus with simple use much more information can be detected than during a resting ECG – an important advantage mainly for those patients where a stress ECG is not feasible due to physical disabilities. The CGM is based on vectorcardiography and offers a stress-free and non-invasive diagnosis of myocardial ischemia. Within only 12 seconds the electric heart activity can be shown three-dimensional, using only 5 electrodes, thus it can be automatically and subjectively evaluated regarding a suspected ischemia. The automatic interpretation suggestions are so precise that they are comparible with the stress ergometry, resp. they are superior to them.In a pilot study with 696 patients of the cardiologic group, CGM reached a diagnostic sensitivity of 84% and a specitiy of 90% regarding diagnostics with relevant coronary stenosis, compared with goldstandard coronary angiography. The actually running multi-centric study CGM@ACS, cardiogoniometry for the early detection of acute myocardic ischemia with ACS symptoms in 45 patients, which was presented in Dresden by Dr. Ralf Tölg, Bad Segeberg, compares CGM directly with coronary angiography. With the automatic CGM score one can quickly confirm or eliminate e.g. a suspected clinical relevant myocardial ischemia. The previous results confirm the easy use in clinical daily life and a high diagnostic potential even with ACS. Tölg specifies the advantage of ischemia localization at resting conditions and the manifold potential fields of application:

  • Pre-stationary determination of chest pain
  • Improvement of time and beds at chest pain unit
  • Ischemia diagnotics without ergometry
  • Localization of ischemia in CCL

Early diagnosis of arteriosclerosis and Hypertension

The arterial vascular system is of great significance to assess cardiovascular risks. Thereby the arterial hypertension and arterial vessel stiffness form a close pathophysiological connection. High blood pressure causes the arterial wall to become stiff which leads to an increase of the pulse wave. Again the already earlier arriving reflected pulse wave leads to an increase in the aortic blood pressure. Various markers were identified and relevant measuring methods were developed for early diagnosis and risk stratification. Many studies could demonstrate that the ankle-brachial index (ABI) , for the early detection of the periferic arterial obstructive disease (PAOD), as preliminary stage of the vascular disease with dramatic consequences, is of major importance.

With the aorta pulse wave velocity (PWV) resp. the augmentation index (AIx) one can see changes at the vascular wall, medical treatment can be started and medical results can be controlled. The enverdis VASCULAR EXPLORER offers a userfriendly and quick diagnostic method with various capacities.

So the ABI can be precisely identified by determination of the highest vascular occlusion pressure of all 4 extremities, without using the extensive doppler-method. Hereby on each part of the body the vascular occlusion pressure of the arteria is plethysmographically measured at upper arm and ankle. The AIx is identified according to the stop-flow method (brachial) by determination of the brachial and approximation of the aortic augmentation index at suprasystolic pressure. PWV of aorta and in periphery are measured by determination of central and central-peripheric pulse wave velocity using pressurized cuffs.

By inflating the cuffs PWV and AIx are automatically calculated by an intelligent software and shown in a graphic. Control of the system is achieved by means of an intuitive Windows software. Supported by current interfaces to office software- and hospital information systems patient data can be easily imported and exported.

Original Source:

MedReview

16.2009

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