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22

© 2014 AngioScan-Electronics LLC

Quick Start

3.4

Performance of Pharmacological Test

Add a patient to the database

,  if he has  not  been  not  registered yet,  or select  the  registered patient  by

double clicking his data. 

Activate "Measurements" window by clicking its header or its button at main window toolbar:

If in "Measurements" window the "Pharmacological Test" tab is not activated, click it:

Put on the sensor of the 1st channel (the one connected to the left device connector) on index finger of
the right hand so that the sensor's wire was on top. During the standard test the patient should sit in a
relaxed position, the hand with a sensor should be placed on a table. The patient should not move during
the whole test. 

In "Measurements" window the graph of patient's pulse waves will be displayed:

Содержание AngioScan-01

Страница 1: ......

Страница 2: ...of Occlusion Test 22 4 Performance of Pharmacological Test Chapter IV AngioScan Medical Tests 27 27 1 PPG Contour Analysis 27 Patient preparation requirements 28 Test procedure for contour analysis 2...

Страница 3: ...t 60 Quick search and history of patients selection 62 Search Database 63 DeletePatients 64 EditNewPatientData 64 Mark Several Records for Group Operations 65 Patients Database Window Setup 66 HTML fi...

Страница 4: ...t AngioScan Database 107 Database Backups 107 2 Program Messages 107 5002 107 12129 107 13002 107 13006 107 13009 108 13012 108 13015 108 13017 108 13025 108 13027 108 13032 108 13033 108 13043 108 13...

Страница 5: ...Chapter I...

Страница 6: ...umentation s set The complex runs under IBM PC with minimum system requirements Operating System Windows 98 NT 2000 XP Processor Pentium III 500 MHz and over Random Access Memory RAM 128 MB Video Card...

Страница 7: ...unpacking AngioScan device check its completeness in accordance with the specification 4 The tests should be performed 1 minute or more later after switching on the AngioScan device connected to comp...

Страница 8: ...4 2014 AngioScan Electronics LLC Introduction...

Страница 9: ...Introduction 5 2014 AngioScan Electronics LLC 1 7 Certificate in Regulatory Compliance...

Страница 10: ...6 2014 AngioScan Electronics LLC Introduction 1 8 FSR Registration Certificate...

Страница 11: ...Introduction 7 2014 AngioScan Electronics LLC 1 9 Patent Certificate for Invention...

Страница 12: ...Chapter II...

Страница 13: ...nstaller checks already installed versions of AngioScan software and proposes to transfer working environment of existing version to the updated one Workingenvironment contains AngioScan setting files...

Страница 14: ...y action It might take some time several seconds to connect USB device after driver installation so that the system could initialize device s parameters During that time the device will not operate If...

Страница 15: ...Chapter III...

Страница 16: ...n folder Connect the sensors to device connectors 1st channel sensor is enough for conducting PPG Contour Analysis and Pharmacological Test 2 sensors are necessary for Occlusion Test performance 1st c...

Страница 17: ...patient to Database Go to Patients Database window To do so click the header or toolbar button of the main window Patients Database window will activate Click New toolbar button The dialogue will ope...

Страница 18: ...close the patient will be registered in the database and Measurements window will activate Performance of PPG Contour Analysis Performance of Occlusion Test Performance of Pharmacological Test 3 1 Us...

Страница 19: ...veness of the current treatment for example hypertension heart disease diabetes it is better to conduct test in the morning in order to eliminate the influence of circadian daily rhythms 1 Tobacco smo...

Страница 20: ...ire was on top During the standard test the patient should sit in a relaxed position the hand with a sensor should be placed on a table The patient should not move during the whole test In Measurement...

Страница 21: ...Quick Start 17 2014 AngioScan Electronics LLC To save test results in database click Save toolbar button The dialogue will appear where one can enter a comment to the scan...

Страница 22: ...ot been not registered yet or select the registered patient by double clicking his data Activate Measurements window by clicking its header or its button at main window toolbar If in Measurements wind...

Страница 23: ...Quick Start 19 2014 AngioScan Electronics LLC Wait for a few seconds until the waves become more stable and then click Record toolbar button or press F9 key The data recording will start...

Страница 24: ...f until the pressure is 220 240 mmHg and maintain this pressure throughout the occlusion phase During the test graphs in measurements window will look like it is shown on the following picture Occlusi...

Страница 25: ...Quick Start 21 2014 AngioScan Electronics LLC To save test results in database click Save window toolbar button The dialogue will appear where it is possible to enter a commentary to the scan...

Страница 26: ...ow toolbar If in Measurements window the Pharmacological Test tab is not activated click it Put on the sensor of the 1st channel the one connected to the left device connector on index finger of the r...

Страница 27: ...a recording will start Approximately 1 minute after the start of the test the patient can take the medicine which effect is test s subject Duration of pharmacological test is to be defined by physicia...

Страница 28: ...24 2014 AngioScan Electronics LLC Quick Start To save results in the database click Save window toolbar button The dialogue will appear where it is possible to enter a commentary to the scan...

Страница 29: ...Quick Start 25 2014 AngioScan Electronics LLC...

Страница 30: ...Chapter IV...

Страница 31: ...in the supine or seated position The patient s hands should be placed at the heart level The test results recorded in the supine or a seated position have marked differences This is due to the change...

Страница 32: ...he optical sensor on the index finger of the right hand such that the sensor cable is on the same side of the finger as the finger nail The sensor connected to Channel 1 Ch1 on the device should be pl...

Страница 33: ...SIr Reference Stiffness Index RI Reflection Index AIp Augmentation Index AIp75 Augmentation Index at HR 75 AGI Aging Index VA Vascular Age ED Ejection Duration PD Pulse Duration ED Ejection Duration...

Страница 34: ...lysis Augmentation index AIp is expressed as a percentage of the pulse pressure This parameter reflects the contribution of the reflected pressure waves to the arterial blood pressure and identifies t...

Страница 35: ...n the heart rate This is due to the fact that the first harmonic of the pulse wave uses most up to 60 70 of the total energy of the heart muscle contraction Therefore the first harmonic and therefore...

Страница 36: ...ation of pulse waves and is typical for the elderly patients with hypertension and an increased stiffness of arteries The pulse wave types in this situation are of types A or B This form of pulse wave...

Страница 37: ...pulse wave is characterized by the maximum of the reflected wave in the middle of systole and the point of projection on the curve is almost the same as the global maximum of the pulse wave This type...

Страница 38: ...tem In addition it is useful in communicating with patients since it allows one to easily explain the state of the patient s cardiovascular system The vascular age index is used widely Takazawa A simi...

Страница 39: ...ients with chronic heart failure type 2 diabetes and alcohol heart damage vanRavenswaaij Arts et al 1993 Heart rate variability is used to stratify the risk of sudden death in patients with severe car...

Страница 40: ...rt failure diabetes mellitus severe heart rhythm disturbances 4 1 4 7 SpO2 Blood oxygen saturation Oxygen saturation of hemoglobin oxygen is a vital index the value of which is determined by Pump func...

Страница 41: ...the pulse wave velocity increases which is reflected in the increase in the stiffness index When the aorta is elastic the stiffness index in the range of 5 to 8 m c and in cases of increasing the rig...

Страница 42: ...n as well as in the prognosis of these patients Laurent et al 2006 4 1 4 9 RI Reflection Index Reflection Index RI is used to assess the contribution of the reflected component to the pulse wave This...

Страница 43: ...derivative of the pulse wave at Korpas et al 2009 The age index AGI is calculated as the difference between the amplitude of the early negative peak and those of the other components to the amplitude...

Страница 44: ...increases the duration of the cardiac cycle decreases as well as does the duration of the systole The faster is the pulse the shorter is the systole For example when the heart rate is 60 beats per min...

Страница 45: ...significantly it can lead to poor perfusion of the myocardium which is a risk factor of heart muscle damage 4 1 4 13 PD Pulse Duration The duration of the pulse wave is determined from the start of th...

Страница 46: ...interval the more elastic is the aorta The parameter has a diagnostic value only when its values are either zero or negative pulse waves of types C and B The parameter has no diagnostic value when th...

Страница 47: ...ary and renal blood flow occurs These factors lead to an increased risk of heart attack and kidney failure Prognostic significance of central blood pressure has been proven in several large studies ev...

Страница 48: ...ents undergoing percutaneous coronary intervention Halcox et al 2009 In these diseases and conditions endothelial dysfunction is often a cause and a marker of local inflammation and a high prothrombot...

Страница 49: ...thelial function Physiological effects of brachial artery occlusion can be described as follows After releasing the cuff pressure the blood flow in the brachial artery increases dramatically by 300 80...

Страница 50: ...d intense exercise has to be terminated one day before the test 3 Immediately prior to the test the subject should rest for 15 minutes in a warm darkened and quiet room 4 During the test the subject s...

Страница 51: ...ange in the amplitude of pulse wave amplitude before and after occlusion is calculated The change in the amplitude characterizes the change in blood volume in small resistive arteries and arterioles 2...

Страница 52: ...litude of the reference channel is made The physiological significance of this occlusion index is to assess endothelial function in small resistive arteries and arterioles When the endothelial functio...

Страница 53: ...of post occlusion nitric oxide production on the smooth muscle of large arteries brachial and radial arteries Phase shift is determined by the time delay with which the pulse waves travel in the occlu...

Страница 54: ...collected the Angioscan software prompts the operator to administer a stimulus After the stimulus has been delivered the pulse wave data is collected continuously to assess the effect of the stimulus...

Страница 55: ...the drug diminishes To study the details of the impact of the drug a contour analysis is carried out Contour analysis of the baseline pulse waves indicates that RI is 32 0 and AIp75 is 16 8 By the 7t...

Страница 56: ...the anatomic differences in the brachiocephalic area 5 The test should be conducted in a warm darkened and quiet room 4 3 2 Pharmacological test procedure Pharmacological test procedure consists of t...

Страница 57: ...his parameter is the ratio of the average amplitude of the pulse waves in the time interval after pharmacological stimulus the pink area on the pharmacological test graph to the average amplitude of t...

Страница 58: ...Chapter V...

Страница 59: ...terface can be either in Russian or in English Please see languages settings in Configure menu Expert Mode AngioScan program can operate in Expert and User modes In User mode some advanced functions a...

Страница 60: ...sensors of both channels are used during the test occlusion test and none of them is put on finger status of channels can randomly change It is not malfunction of device 5 1 AngioScan windows Main wi...

Страница 61: ...ng at window in the bottom part there is a More toolbar button Local menus are different for top and bottom parts Many commands can be performed with the help of hot keys which names are displayed in...

Страница 62: ...in HTML file Data filter Histograms Operations with test results data In the bottom of the database window there is a list of test results performed for patient selected marked by blue background on t...

Страница 63: ...alog toolbar Enter patient s data in the open dialog Fields in bold must to be filled in except Patient ID field The patient s height is indicated in centimeters After entering data click the OK butto...

Страница 64: ...or example if you choose age as a sorting criteria the patients of one age will be sorted according to their names 5 1 1 3 Quick search and history of patients selection Quick search On the left toolb...

Страница 65: ...e sequence of patients selected for test To receive the list click the arrow next to the quick search field To select a patient click the line with his name in the list The patients are sorted accordi...

Страница 66: ...string for a search In the list Search in mark where to search the entered substring In the list Search direction specify the direction of search In the list Match coincidence select how to compare a...

Страница 67: ...all lines containing fields meeting search conditions Then it is possible to perform group operations with all marked records For example one can delete or save as a table in HTML file 5 1 1 5 Delete...

Страница 68: ...Edit new patient data dialog Editing patient data is not available when records filter is switched on 5 1 1 7 Mark Several Records for Group Operations If you mark several entries in the window you ca...

Страница 69: ...with the cursor by holding Shift key To mark all records use Ctrl A keys combination 5 1 1 8 Patients Database Window Setup With the help of Settings toolbar button one can specify fields and their o...

Страница 70: ...able directly in the window by dragging fields headings with the mouse 5 1 1 9 HTML file to save records This function allows to save one or several entries in the form of table in HTML file The saved...

Страница 71: ...rowser will automatically open An example of the table in HTML file 5 1 1 10 Database Filter Setup Records Filter is an advanced option allowing to display only those entries that match with specified...

Страница 72: ...isplayed Insert Condition button opens the dialog where you can set a filtering condition On the top side of the window you can set a field of database records according to which the filtration will b...

Страница 73: ...it will be as it is shown in the picture below for text fields one can specify criteria of matching with substring and for date field to choose a date In the bottom input field which view depends on...

Страница 74: ...conditions it might be useful to prioritize the comparison Insert and Insert buttons that put conditions into the brackets are designed for this purpose When the filter is switched on all entries are...

Страница 75: ...patients of a corresponding height For example it is well seen in the picture that there is one registered patient with a height of 150 centimeters and 9 patients with the height of 178 centimeters 5...

Страница 76: ...of text file for further analysis in PowerGraph program as well as to export data of one or several tests to another AngioScan database for example for sending data to another computer To perform the...

Страница 77: ...nd helps to recalculate one or several scan results saved in database In the process of AngioScan software development data processing algorithms can be changed and thus reprocess will be required for...

Страница 78: ...to change the size of the pictogram by choosing it in Picture size group Open button downloads selected in the list picture to Measurements window without closing the dialog Thereby it is possible to...

Страница 79: ...ll be selected corresponding to the position of the cursor To change to size of the picture select it in Picture Size menu item Thumbnails button is available for trends of PPG contour analysis and op...

Страница 80: ...ve similar toolbars as well as local menus Every tab has a field where the receiving from sensor signal is displayed in real time mode if the device is connected to computer and the sensor is put on p...

Страница 81: ...aph of the received from the sensor signal will be displayed in oscilloscope field of the window If there is no recording of the signal it means that AngioScan operates in signal monitoring mode Meanw...

Страница 82: ...ring stops To resume the signal monitoring remove the sensor from patient s finger and put it on again to change the patient or click Restart button There are all commands corresponding to toolbar but...

Страница 83: ...the bottom part of the window To switch between them select the corresponding tab Pulse Waves Graphs The displayed signal has undergone several levels of filtration during the processing The horizont...

Страница 84: ...de If you move the cursor to a parameter the tooltip with its full name will appear By clicking the arrows near the beats field one can change the number of selected pulse wave By clicking the arrows...

Страница 85: ...rresponding to the column s location on horizontal axis For example the histogram above shows that 54 pulse waves with duration of 0 85 seconds 71 beats per minute were accumulated during the test The...

Страница 86: ...lusion Test Bookmark See the medical description of the test in Occlusion Test section The description of measured parameters see in Measured Parameters of Occlusion Test General rules of test perform...

Страница 87: ...signal amplitude decreases during the occlusion test The horizontal axis chows time in minutes When the test finishes graphs are automatically scaled stretched along the horizontal axis After the test...

Страница 88: ...the bottom right corner shows the pulse waves in a large size and superimposed upon each other that allows to visually compare their shape and phase shift The yellow graph displays the 1st wave channe...

Страница 89: ...intervals As a result of test two lists of Contour Analysis parameters for each channel are created The first list shows the average parameters values taken an interval before the Occlusion test blue...

Страница 90: ...utomatic recalculation of measured parameter values is performed Recalculation of Test Results The calculation of occlusion indexes is based on evaluation of signal parameters before and after the Occ...

Страница 91: ...ice cannot reliably perform the pulse waves selection PPG Contour Analysis Tab displays the results of Contour Analysis after activation To return to Occlusion Test click its header Export of all puls...

Страница 92: ...de of the window and test results are shown on the right The horizontal axis shows time in minutes After the test finishes the graph is automatically scaled stretched along the horizontal axis It is p...

Страница 93: ...he values of parameters displayed either in In the right part of the tab there are parameter values displayed either as absolute values or as values differences Show Absolute values Show Differences W...

Страница 94: ...f mouse cursor in the window The same is performed when clicking twice on the selected point of the chart PPG Contour Analysis Tab activates and displays the results of contour analysis To go back to...

Страница 95: ...ed message is highlighted by a specified background colour To select another message click it and use the cursor control keys Local Menu The local menu of the window contains the following commands an...

Страница 96: ...014 AngioScan Electronics LLC Graphic Interface 5 2 1 File Menu ConfigurationFiles Opens a submenu for operations with configurationfiles Exit Closes AngioScan session Or Alt F4 or Alt X keyboard shor...

Страница 97: ...nloaded or saved with the help of File 8 Configuration files Besides AngioScan uses session files that contain information about the session and indicate which screen configuration file and option fil...

Страница 98: ...lly After restarting AngioScan program it must be set up again Play sounds on occlusion start end Produce a sound signal when to start and to finish the occlusion during the Occlusion test performance...

Страница 99: ...er in computer database or for editing of user s data if the patient is already registered You will be asked to enter the name surname date of birth and etc Further the entered first and second names...

Страница 100: ...ption is turned on the sounds selected in the list below are switched on Device Memory Information about memory status Apply the Settings Records the settings in device The changes are immediately dis...

Страница 101: ...ss of contour analysis the fewer number waves is accumulated the index is not calculated Font size for result lists Allows to set font size of measured test parameters Scan simulation acceleration Sho...

Страница 102: ...l the purpose and the consequences of changes Performing tests with wrong settings might give unreliable results or even make impossible any test performance 5 2 3 2 Environment Dialog Here one can cu...

Страница 103: ...cription Color scheme Sets name of color scheme It can be printed out or selected from a list of recently used ones Save button saves the scheme to disk Delete button deletes it Colors A list of color...

Страница 104: ...ion by right clicking the cell where row with a command and Key 1 or Key 2 column meet 5 2 3 2 4 Toolbar Bookmark Toolbar tab of Environment dialog activates toolbars and buttons of AngioScan windows...

Страница 105: ...by a switch with the following positions Overwrite log file after each start Specifies to create a new file for each session and delete the former file if it exists Append messages to logfile Specifi...

Страница 106: ...es from one number system to another Result can be copied to the clipboard Dialogitem Description Expression The field for expression or number input Copyas Specifies the format of the result to be co...

Страница 107: ...ed by yellow Click Load test result or double click the row with test result to load the results without leaving this dialog 5 2 5 Windows Menu Commands of this menu control the arrangement of windows...

Страница 108: ...cuted file version Devicebootloader version Version of device resident software It is displayed only when the device is connected to computer Device target software version Downloadable version of dev...

Страница 109: ...Chapter VI...

Страница 110: ...fault under the name of common database The common database is not deleted during the uninstallation of AngioScan package and it is not upgraded during the installation of updated versions Thus all An...

Страница 111: ...ges 6 2 1 5002 Floating point number is entered In this situation it is necessary to enter an integer 6 2 2 12129 Previous test results for the specified patient are not saved If you perform the actio...

Страница 112: ...teristics of pulse waves have a large scatter 6 2 13 13043 The test is completed successfully and a sufficient for analysis number of pulse waves is accumulated The test result can be saved in the dat...

Страница 113: ...id directory name It can be set in AngioScan Settings dialogue It is not a fatal error You can continue without creating database backup copies 6 2 18 13088 It is necessary to enter the required infor...

Страница 114: ...e about to transfer data of one patient s test results to another patient It might be necessary if the test was performed for a patient selected by mistake as well as after Database import See Test re...

Страница 115: ...the user specified has been already registered in computer s database Test results saved in device will be transferred to the already registered user 6 2 34 13123 The message tells about the number of...

Страница 116: ...data go to Settings AngioScan Settings Stand alone device tab as well as to patients database dialogue 6 2 37 New test data found in memory Dialogue When connecting stand alone device AngioScan 01P t...

Страница 117: ...m analyses the data stored in memory of stand alone device If there are records of users not registered in computer s database AngioScan offers to enter data for each user first name second name date...

Страница 118: ...statistics Dialog 103 Toolbar Tab Environment dialog 100 Tools menu 101 View Menu 93 Windows Menu 103 CM settings Stand alone device Tab 95 About AngioScan 104 Add a new patient 59 AngioScan settings...

Страница 119: ...ew versions of AngioScan 103 new versions of AngioScan check 104 Patients Database window 56 Quick search database 60 Quick Start 12 Recalculate of Scan Results 73 Record filtering condition 68 Record...

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