Aortic pressure better for diagnosing congestive
heart failure and coronary heart disease
5 January 2012
Prof. Uwe Nixdorff from the European Prevention Centre,
Düsseldorf is advising cardiologists to combine intima media thickness
(IMT) measurement with Aloka’s ultrasound scanner pulse wave intensity
function to check for unseen coronary heart disease.
“This technique is currently seldom used," he said, "however, in my
experience it provides a more complete picture and enables me to
treat patients earlier for life-threatening conditions that are
often missed using conventional approaches”
Aloka is collaborating with Prof. Nixdorff to advocate
cardiologists worldwide begin using new functionalities for earlier
diagnosis of coronary heart disease — enabling a preventative rather
than a reactionary approach to this pandemic disease.
The problem with exclusively using older conventional techniques,
like checking a patient’s blood pressure, is that it only enables
the clinician to see what is happening externally and does not
necessarily expose dangerous pre-clinical risk factors acting on the
However, by combining IMT (intima media thickness) — the
thickness of the arterial walls — with pulse wave intensity, which
is the level of stress felt by the heart muscle (diastolic and
systolic left ventricular function), and how this translates to
blood flow behaviour, the clinician will be able to get a
simultaneous overview of both the heart’s functional and physical
properties for the first time. This provides an invaluable insight
into the early stages of heart failure and preclinical artery
disease, enabling appropriate treatment to start more quickly,
potentially saving lives.
For example, if the patient has the early stages of
atherosclerosis (hardened and narrower arteries) it forces the
myocardium muscle (heart muscle) to work increasingly hard, building
it up (left ventricular hypertrophy) and resulting in increased
pressure on the heart walls when ejecting blood (afterload). Over
time the heart’s increased muscle mass will also cause difficulty
re-filling during the diastole stage (diastolic relaxation
dysfunction) and these factors collectively will result in systemic
or pulmonary hypertension, and ultimately heart failure.
Aloka’s e-flow technology provides a new blood flow imaging mode
which permits high spatial and temporal resolution. Combined with
e-tracking technology, ALOKA’s unique analytical system, this
facilitates the cardiologist in simultaneous access to vital
information on the previously unforeseen aortic pressure — an early
warning sign of possible CHD.
Prof. Nixdorff, added: “The ability to provide a complete
pathophysiological perspective of atherosclerosis as a systemic
process is unique to Aloka systems, and it enables for a
comprehensive understanding of the entire ventriculoarterial
"The crucial difference with e-tracking is that it’s so accurate
that it can even detect sub-clinical levels of vascular disease,
making it ideal for earlier diagnosis and screening programmes. If
we are able to see disease before it has taken hold of patients we
can quickly move to an appropriate drug regimen — like ace
inhibitors or AT-II receptor antagonists — and prevent unnecessary
deaths from this pandemic disease”.
The only current impendent to widespread adoption of these newer
more accurate predictive techniques is appropriate training, and in
order to eliminate ‘user dependence’ Prof. Nixdorff and Aloka are
running training initiatives around the globe and at major
conferences throughout the year.
Prof. Nixdorf presented his findings and experiences at this
year’s EuroEcho in December (7-10), 2011.