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Screening of cardiovascular systems based on multi-parameter analysis

Description, comparison with clinical data and clinical exploitation of a non-invasive and relatively inexpensive method for screening cardiovascular systems based on multi-parameter analysis of heart haemodynamics and vascular perfusion in selected areas of the body.

The multi-parameter analysis of the heart haemodynamics and the vascular perfusion constituting the theoretical basis for the present project is based upon rheographical measurements of the blood flow, the electric conductivity of skin and the examination of arterial blood pressure. The pathological changes of the heart and the vascular system are clearly reflected in the condition of internal organs and in the deterioration of the perfusion of peripheral tissues. The results obtained in the course of direct measurements: the amplitude of the first derivate of impedance, the ventricular ejection time, the base impedance, the arterial pressure and the skin impedance are subjects of the current analysis and are collected for further processing /1, 2, 3/. The application of suitable calculation algorithms permits consecutive parameters such as the volume index of circulating blood in particular areas of body, the volume index of circulating blood in the major circulation, the average arterial pressure, the contractility index of myocardium, the stroke volume and other parameters to be obtained. In total, 370 parameters for the evaluation of the haemodynamics in the individual areas of the body are obtained. The proposed methods permit the performance of the measurements in a non-invasive manner and in a way that is not burdensome for the patient. The examinations are performed in two positions of the body with a view to determining the influence of the gravitation on the regulatory mechanisms of the circulation system. The alterations of parameters under the influence of the changes of the body position is an important group of information that is taken into account in the systemic analysis. An analysis of all the resulting parameters is performed in relation to the standards established for the corresponding age groups, sex, body height and weight and, with regard to women, in relation to the phase of menstrual cycle as well as to the various types of orthostatic reactions, the fall, the lack of alterations, or the growth of minute heart volume after return to erect position /4/. There have been reported attempts of making clinical use of the aforementioned theoretical bases for the multi-parameters analysis of rheographical and electrometrical values and pressure measurements with a view to determining the level of blood supply and circulation in the examined areas of the body /5/. With this aim in view, a special prototype measuring instrumentation has been developed for experimental examinations allowing the measurement of basic biomedical parameters for further analysis of heart haemodynamics and vascular perfusion. The experimental prototype consists of the measuring part incorporating the electrode system, the rheographical signal generator, the amplifiers, the alternating current converters and the analytical part incorporating a computer with suitable software. The first data obtained under the conditions of experimental examination are encouraging and have created inspiration for conducting examinations as planned in the present project. The performance of further examinations has been foreseen in order to verify the clinical usefulness of the said method, the repeatability of used algorithms, the range of standards and values relevant to pathology and the conceiving of a special prototype programme of computer analysis. The project necessitates the development of proper technical documentation for the production of the equipment, which will enable the safe performance of examinations indispensable for the clinical verifications. Clinical examinations will be carried out in a representative group of patients in medical centres having the necessary experience and adequate equipment that permit the proper diagnosis and documentation of pathological changes or their univocal exclusion. The examinations will be carried out on patients segregated into groups, according to their clinical diagnosis, with the use of instrumentation and the system of multi-parameter analysis. It should be emphasized that the said examination comparable with ECG investigation is totally harmless to the patients and the medical staff, and its only inconvenience is the duration of examination - about 40 minutes. It is planned to carry out the examinations in clinical centres in POLAND and in hospital departments and outpatient departments of vascular surgery in LITHUANIA. The pathologies under examination will refer to the proven blood supply disturbances apparent in the defined areas of the body. The creation of appropriate groups of sick persons according to the stage of the disease and its correct diagnosis will be specified by the physicians participating in the realisation of this project. The results obtained from the multi-parameter analysis and the derived indications as to the further diagnostics or resignation of it will be compared with the previously determined diagnoses. The project aims to develop a technique for the non-invasive screening examination of cardiovascular systems based upon the multi-parameter analysis of heart haemodynamics and vascular perfusion in the defined areas of the body. The usefulness of the said system in the physician's daily activities will be determined and its usefulness as a screening test method in the early diagnosis of diseases with the use of non-invasive and relatively inexpensive medical equipment. The positive results obtained in the course of the project implementation will constitute the basis for the development of the usable version of the system in question and its widespread dissemination in Europe as a non-invasive screening method for the initial diagnosis of cardiovascular systems. 1. Belardinell R. et al: Comparison of impedance cardiography with thermodilution and direct Fick Methods for non-invasive measurement of stroke volume and cardiac output during incremental exercise in patients with ischemic cardiomyopathy. American Journal of Cardiology 1996, vol.77, 1293-1301. 2. Spinale F.G., Reines D., Craword F.A.: Comparison of bioimpedance and thermodilution methods for determining cardiac output: experimental and clinical studies. Ann. Thorac. Surg. 1988, 45, 321-425. 3. Jewkes C. et al: Non-invasive measurement of cardiac output by thoracic electrical bioimpedance: a study of reproducilibity and comparison with thermodilution. British Journal of Anaesthesia 1991, 67, 788-794. 4. Rodeheffer R.J., Gersetenblith G., Beard E.: Postural changes in cardiac volumes in men in relation to adult age. Experimental Gerontology, 1986, 21, 367-378 5. Bielkania G.: Curative-diagnostical expert system 'Antropos'. 4th International Congress of physical Education & Sport, Komoti, Greece, 17-19.05.1996 6. Palko T.: Impedance study of body tissues. Med. & Biol. Eng. & Comput., 1999 vol. 37. Suppl. 1, 58-60. Keywords: screening, multiparameters, haemodynamics.
Acronym: 
CAVASCREEN
Project ID: 
2 939
Start date: 
02-01-2003
Project Duration: 
36months
Project costs: 
1 800 000.00€
Technological Area: 
Heart and blood circulation illnesses
Market Area: 

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