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ALAM MEDICAL

 

 

Diagnóstico y Evaluación Arterial: Velocidad de Onda de pulso (VOP) y Presión Central

 

 

Complior Analyse

 

 

 

Velocidad de Onda de Pulso

 

 

 

Presión Central

 

 

 

Protocolos de Medición

 

 

Informaciones Básicas

 

 

 

Conceptos  Básicos de VOP:  Velocidade de Onda de Pulso

 

 

 

Conceptos Básicos de
Presión Central

 

 

 

Protocolo de Medición con Complior Analyse

 

 

 

Validación do Complior Analyse

 

 

 

Algunas Publicaciones

 

 

 

Folletos

 

     
 

COMPUMEDICS

 
 

Equipos de Diagnóstico en las Áreas de Sueño, la Neurología y la Cardiología

 
  Somnea  
  Somt?/a>  
  Somt?PSG  
  E-Series EEG / PSG  
  SynAmps2 Neuvo  
  Siesta  
  Safiro  
  Grael  
  Xegis EMG / PE / IOM  
     
 

NEUROSCAN

 
 

Softwares, Amplificadores
y Accesorios para la Investigación en Neurociencia

 
  Maglink  
  Scan NuAmps Express  
  SynAmps RT  
  Stim2  
  Curry 6  
  Source 2  
  Source 5  
  Scan 4.5  
  Access SDK  
  Quik-Caps  
  QuikCell  
       
 

MEDOC

 
 

Sistemas de Neuro Diagnóstico para Pesquisa
da Dor Cônica e Aguda

 
  AlgoMed  
  Covas  
  Pathway  
  Pathway Modelo ATS  
  Pathway Modelo ATS
Accessories
 
  Pathway Modelo Cheps  
  Pathway Modelo Cheps Acessories  
  TSA II Neuro Sensory
Analyzer
 
  TSA II
Accessories
 
  VSA-3000 - Vibratory
Sensory Analyzer
 
       
 

ALPHA OMEGA

 
 

Equipos para investigación neurofisiológica en animales

 
 

Registro y Estimulación  
   

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AlphaLab SnR  
   

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TeleSpike  
   

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TeleSpike Mini  
 

Micromanipuladores  
   

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EPS  
   

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FlexMT  
   

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MultiDrive  
 

In Vitro MEA  
   

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Array de
Microelectrodo In Vitro
 
 

Accesorios Neurociencia  
   

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Electrodos  
   

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MEA - Array de Microelectrodo  
   

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FMA - Array de Microelectrodo Flotante  
   

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LMA - Array de
Microelectrodo Linear
 
   

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WMA - Microwire Array  
   

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Electrodo de Inyección  
       
 

UGO BASILE

 
 

Instrumentos para
Animales de Laboratorio

 
  Dolor e Inflamación  
  Coordinación Motora, Actividad y Fuerza de Agarre  
  Ventilación y Gases Anestésicos  
  Condicionamiento y Recompensa  
  Laberintos y Monitoreo  
 

Baño de Órganos, Grabación y Estimuladores  
  ECT, Productor de Lesiones, Diversos  
  Presión Sanguínea y Funciones Vitales  
  Metabolismo y Comportamiento Alimentario  
  Fijación por Irradiación
de Microondas
 
       
     XLTEK  
 

Equipos de
neurodiagnóstico:
EMG, PE y IOM

 
 

NeuroMax EMG / PE  
 

Protektor IOM  
 

XCalibur EMG / PE  
       
     CAREFUSION  
 

Equipos de
neurodiagnóstico:
EEG, MG, PE y IOM

 
 

Endeavor CR IOM  
 

Synergy N-EP - EMG / PE  
 

Synergy N2 - EMG  
 

Synergy T2 - EMG  
 

Synergy T-EP - EMG / PE  
 

NicoletOne  
 

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-
-
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Ambulatory EEG
cEEG
nEEG
LTM
Sleep
vEEG
 
 

VikingQuest IOM  
 

VikingQuest EMG  
 

VikingSelect  
 

VikingSelect IOM  
       
 

BIOLOG

 
 

Sistema de Identificación Microbiana

 
 

GEN III
Identificación
Microbiana
 
 

OmniLog
Incubación de Placas
 
 

EcoPlate
Análisis de Comunidades Microbianas
 
 

FF MicroPlate
Identificación de Hongos Filamentosos y Levaduras
 
 

Rainbow Agar
Detección de

E. coli O157
 
 

Rainbow Agar
Detección de
 H2S Salmonella
 
 

Rainbow Agar
Detección de

Shingella / Aeromonas
 
       
 

AEROCRINE - BIOSCAN

 
 

Medidores Portátil de
Óxido Nítrico (FENO)

 
 

Niox Mino  
       
 

SLEEP SUPPORT

 
 

Sensores e electrodos para EEG, PSG, PE, EMG y ECG

 
 

Cinturones de Esfuerzo Respiratorio, Torácicos
y Abdominales

 
 

Sensores de Flujo Respiratorio Buconasal  
 

Transductor de Presión Flujo Respiratorio y Ronquido por Cánula  
 

Sensores de Ronquido Micrófono  
 

Electrodo de Superficie de Copa Orificada Reutilizable
Sueño - EEG - Mapeo

 
       
Inglês Español

Research instrument - More information

?nbsp; Complior Analyse  ?nbsp; Pulse Wave Velocity  ?nbsp; Central Pressure  ?nbsp; Measurement Protocol  ?nbsp; Brochures  ?nbsp; Info Center  ?/font>

     
 
Basics on Central Pressure
 
     
     
 

Central Pressure: Definition

 
 

Central pressure is the pressure in the main large arteries (aorta, carotids). It represents the pressure load of target organs such as the heart, the brain and the kidneys. However central pressure is not equal to peripheral pressure measured with a standard cuff and it has been shown that central pressure has a superior cardiovascular prognostic value compared to brachial pressure. (Safar 2002, Agabiti-Rosei 2007,Pini 2008, Wang 2009, Vlachopoulos 2010)

 
 

 
  Not only central systolic and central pulse pressures are different from peripheral pressures but the whole waveform is different. (London 2010).  
     
 

Clinical importance of central pressure

 
 

?We don’t die from the arm ? (Pr D. Chemla)

 
 

Central pressure is the one felt by target organ such as the heart, brain and kidneys. For this reason, central pressure is related to renal diseases, stroke and cardiovascular risk in general (Vlachopoulos 2010)
Moreover, epidemiological studies have shown that central pressures values were superior to cuff pressures to predict cardiovascular death

 
 

 

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?Brachial BP had no predictive value for mortality after adjustment. […] 1st evidence than carotid PP level and mostly, the disappearance of PP amplification, are strong independent predictors of mortality.? (Safar 2002)

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“Hazard ratio per 10mmHg increase in central PP : 1.084   […] Brachial PP did not predict major CV events.?/span> (Chirinos 2005)

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“Central PP predicted cardiovascular events more strongly than brachial PP?/span> (Roman 2007)

 

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Central PP was independently related to primary cardiovascular end points, peripheral BP parameters were not. (Jankowski 2008)

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“Superior prognostic utility of central compared with brachial BP?(Pini 2008)

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“central BPs but not brachial BPs predicted cardiovascular mortality independent of conventional risk factors?Wang 2009)

   
 

How to measure central pressure ?

 
  The ideal methodology to obtain central pressure is with an invasive line. However this is not feasible in clinical routine and non invasive carotid pressure is often used instead. (Safar 2002, Pini 2008,Wang 2009) Indeed, with similar geometry and structure and their close proximity, carotid and aortic arteries have virtually identical pressure waveforms. (Kelly 1989, Chen 1996).
  Another non-invasive methodology is sometimes used. It provides an estimation of central pressure waveform from the radial signal and a mathematical model (transfer function or regression on SBP2) which is subject to controversies.
     
 

Pulse wave propagation and reflection

 
 
 

The shape of the pulse waveform is result of the summation of a direct wave and reflected wave which both propagate along the arterial tree.

 
 

The reflected is created by bifurcations, diameters changes, thus by impedance changes. To a first approximation, it can be considered that the reflected wave comes mainly from the lower body.

 

Direct and reflected waves change shape during their travel along the arteries depending on vessels characteristics

 

 

 

In the aorta, an elastic artery, direct and reflected wave are subject to Windkessel effect (energy storage during systole for later restitution during the cardiac cycle).

On the other hand, subclavian and brachial arteries are muscular arteries where only the propagation in tubes of decreasing diameter is to be taken into account

 
 
 
 
 
 
 
 

As a result, shapes of aortic and brachial waveforms are very different leading to a difference in central and peripheral systolic pressure values. There is an amplification from the aorta toward the periphery depending on vascular characteristics (Pauca 1992Smulyan 2008). In general, the amplification is higher in young healthy adults while it tends to decrease with age and cardiovascular diseases.

 
     
 

Parameters describing central pressure waveform

 
  The shape of the aortic pulse wave depends on the respective timing and amplitude of the direct and reflective waves.  
  Aortic stiffness (and hence PWV) affects the arrival of the reflective wave. In an elastic aorta, the reflective wave will arrive later and will add to the direct wave only in late systole. On the contrary, in a stiff aorta, the reflected wave will arrive sooner and will significantly increase the aortic pulse pressure.  
   
     
  Stiffness is not the only parameter influencing the shape of the waveform. Vascular tone (peripheral vasodilatation or vasoconstriction) plays a role on the amplitude of the reflected wave, while heart rate induces changes on the relative duration of direct and reflected waves.    
     
 

?nbsp; Complior Analyse  ?nbsp; Pulse Wave Velocity  ?nbsp; Central Pressure  ?nbsp; Measurement Protocol  ?nbsp; Brochures  ?nbsp; Info Center  ?/font>

 

 IMPORTANT:
The Complyor Analyse the moment is intended just for Scientific Research and imported could be performed only by scientists, researchers or institutions of science and technology.

   BiolinkArg S.R.L - 2011