The loss of elasticity of the arteries:
Although death due to heart disease has now been overtaken by cancer, mortality is still 45% for the Western population. A large number of risk factors has been identified; some can be influenced, others not:
Age, gender (M>F), genetic predisposition, smoking, physical inactivity, hypertension, obesity, metabolic syndrome / diabetes, stress, excessive alcohol consumption, bad teeth, environmental influences, such as toxic metals (mercury, cadmium and lead ), poor nutrition, laboratory tests: elevated LDL cholesterol, decreased HDL cholesterol, elevated triglycerides, elevated HbA1c (sugar), elevated lipoprotein (a), increased CRP (inflammatory marker), increased uric acid, elevated homocysteine, and many others.
All these different influences have an adverse effect on the functions of vascular wall of the arteries. Functions of the vessel wall are the regulation of blood pressure and keeping the endothelium intact, the “innermost” part of the vessel wall. While the endothelium remains intact, there will be no loss of function of the arteries. As long as there is no loss of function, only minimal arteriosclerosis (hardening of the arteries) can occur. The extent of atherosclerosis is correlated with arterial stiffening.
Loss of arterial elasticity is an end process resulting from many years of impaired arterial functioning.
There are various methods for cardiovascular examination. The ECG shows signs of oxygen deprivation, when coronaries are blocked for 70% or more. Other invasive procedures such as cardiac catheterization will detect abnormalities at an earlier stage, but such tests are only performed if people have complaints.
The AORTOGRAM is performed with the Arteriograph®. This is a relatively new method that is so sensitive, that abnormalities can be detected in a very early stage .
The Arteriograph measures both the loss of arterial functioning and arterial stiffening.
Loss of function is expressed in the unit AIX: the Augmentation Index. The AIX is a measure of the total resistance of all blood vessels. Against this resistance, the heart pumps every stroke. The higher this resistance is, the higher the work load for the heart. An increased resistance of the blood vessels is caused by loss of function of the endothelium.
Loss of elasticity (stiffness) of the arteries is expressed in the unit of measure PWV: Pulse Wave Velocity, or the speed at which the aortic pulse is going. In case of aortic stiffening the speed of the pulse increases. The higher the PWV, the more stiffening of the aorta has already occurred.
Both loss of function and stiffening are categorized in four groups:
Aix PWV
Optimal <30% <7,0 m/s
Normal -30% to -10% 7,0 m/s to 9,7 m/s
Elevated -10% to + 10% 9,7 m/s to 12,0 m/s
Abnormal >10% >12,0 m/s
The Arteriograph also measures the central blood pressure (SPBao). This central pressure is a significantly better tool than the blood pressure taken at the arm. To evaluate the effects of antihypertensive medications it is better to rely on central blood pressure than on brachial blood pressure.
Anatomy of the coronary arteries