ES TECK SYSTEM • GENERAL INFORMATION’S ES Teck System (Cardiology) • HRV Photoelectrical Plethysmograph HRV ( short time) HRV Reference: Task Force of The European Society of Cardiology and The North American Society of Pacing and Electrophysiology (1996) SpO2 and Photoelectrical Plethysmograph References: • Nichols WW, O’Rourke MF. McDonald’s : Blood Flow in Arteries:Theoretical, Experimental and Clinical Principles. London: Arnold, 1998. • Takazawa, Kenji; Tanaka, Nobuhiro; Fujita, Masami; Matsuoka, Osamu; Saiki, Tokuyu; Aikawa, Masaru; Tamura, Sinobu; Ibukiyama, Chiharu :Assessment of Vasoactive Agents and Vascular Aging by the Second Derivative of Photoplethysmogram Waveform Hypertension: Volume 32(2)August 1998pp 365370 • IToshiaki OTSUKA , Tomoyuki KAWADA , Masao KATSUMATA , Chikao IBUKI , and Yoshiki KUSAMA ndependent Determinants of Second Derivative of the Finger Photoplethysmogram among Various Cardiovascular Risk Factors in Middle-Aged Men Hypertens Res Vol. 30, No. 12 (2007) • Toshiaki Otsuka, , Tomoyuki Kawada, Masao Katsumata,Chikao Ibuki, :Utility of Second Derivative of the Finger Photoplethysmogram for the Estimation of the Risk of Coronary Heart Disease in the General Population Circ J 2006; 70: 304 – 310 • Alberto Avolio : The finger volume pulse and assessment of arterial properties .Journal of Hypertension 2002, 20:2341–2343 • Oximeter Guidelines 1998 ES Teck Measurements Heart Rate and sinus node depolarization Autonomic Nervous System and Heart rate variability SpO2 AND Photoelectrical Plethysmography SpO2 Probe Infra red/ Red 660/905 nm Photo diode SpO2 % PR Vascular waves SpO2 ANALYSIS Oxygen - hemoglobin Affinity Changes. The functions of hemoglobin are oxygen pickup and delivery. The hemoglobin has an affinity (the strength of bond between oxygen and hemoglobin) that can be increased or decreased due to various situations. If hemoglobin has an increased affinity, it is highly saturated; but oxygen is less available for release to the tissues due to the strong bond. The reverse is also true. Vascular Wave Analysis Analysis by Acceleration and Second derivative Analysis of the Second derivative with age Analysis of the second derivative and diseases : b/a Analysis of the second derivative and diseases : d/a Specificity and sensitivity of the b/a and d/a indicators Specificity and sensitivity of the b/a and d/a indicators Ref. Toshiaki OTSUKA , Tomoyuki KAWADA , Masao KATSUMATA , Chikao IBUKI , and Yoshiki KUSAMA Independent Determinants of Second Derivative of the Finger Photoplethysmogram among Various Cardiovascular Risk Factors in MiddleAged Men Hypertens Res Vol. 30, No. 12 (2007) Results of ES Teck HRV STATISTICAL RESULTS SpO2 and Photoelectrical Plethysmograph results E.S TECK COMPLEX • GENERAL INFORMATION’S ES TECK COMPLEX THE NATURAL EIS UPDATE ES Teck Complex Measurements CROSS ANALYSIS EIS BIA Cross Analysis SpO2/PP HRV E.S TECK COMPLEX INTENDED USES • HRV module: To analyze the basic rhythms of the NN or RR intervals in electrocardiograms, both in the time domain and in the frequency domain (short time 5 minutes) • It only provides numerical analyses of the input electrocardiogram. • Estimate of the parasympathetic and sympathetic system stimulation. • PP module: Analyze the pulse waveform by photoelectric plethysmography and Pulse rate. • Evaluation of Large and small artery • EIS module: • Monitoring of diseases, functional and lifestyle ‘ treatments • Adjunct to conventional diagnosis of ADHD children • BIA module : • Calculation and Historical Tracking of body composition Body Impedance Analysis (BIA) Measurement of the Resistance and Reactance in Tetra polar mode with a frequency of 50 KHz Resistance and Reactance measurements • Resistance is a measure of how difficult it is for electricity to flow through an object. • Reactance Most objects have some capacitance, which is a measure of ability to store an electrical charge. The more capacitance the object has, or the faster the current changes direction, the less the object will “react” to the current. EIS B I A Peer reviews formula • Total Body Water :TWB 5-19 y.o Davies et al 1988 20-80 y.o Lukaski and Bolonchuk 1988 Adult obese subjects: Segal et al 1988 • Fat free fat mass: 7-15 y.o Deurenberg et al 1991 16-83 y.o Deurenberg et al 1991 • Extra cellular water volume : EWC Sergi G, et al 1994 Phase Angle Impedance Components XC Z Phase Angle R Xc = 1 / (2 * PI * F * C), X L C – Capacity [Farad] Phase Angle = Arctan (Xc / R) Z Z R XC XL Clinical application in survival in colorectal cancer The survival curves for the 2 categories of phase angle are shown. Patients with a phase angle < 5.57 had a median survival of 8.6 mo (95% CI: 4.8, 12.4; n = 26), and those with a phase angle > 5.57 had a median survival of 40.4 mo (95% CI: 21.9, 58.8; n = 26); this difference was significant (P = 0.0001). Impact of phase angle in liver cirrhosis NEW INTERFACE E.S TECK RESULTS EIS ANALYSIS HRV STATISTICAL RESULTS HRV RECORDS HRV GEOMETRICAL ANALYSIS SpO2 RESULTS AND MANAGEMENT OF THE PHOTOELECTRICAL WAVE PHOTOELECTRICAL PLETHYSMOGRAPH ANALYSIS AND RESULTS Vascular Indicators • PH : Relation with blood flow of small artery • EEI : Relation with LV ejection and elasticity of large artery - LV Ejection Insufficiency • DDI : Relation with contraction and tension of small artery - Hypertension & Arteriosclerosis • DEI : Relation with blood flow to vein system. • Etc (Estimated Cardiac Ejection time) : 260~380 Function of left ventricle BODY COMPOSITION RESULTS Body Composition follow up E.S TECK COMPLEX • CROSS ANALYSIS • MODELING AND BODY SYSTEMS’ INDICATORS DIGESTIVE SYSTEM INDICATORS BRAIN INDICATORS CARDIOVASCULAR INDICATORS HORMONAL INDICATORS RESPIRATORY SYSTEM INDICATORS GENERAL METABOLIC INDICATORS UROGENITAL AND RENAL INDICATORS Follow up of all the indicators Follow up of the Cerebral neurotransmitters Medications monitoring indicators Medications monitoring indicators Medications monitoring indicators Medications monitoring indicators ADHD Children profile and diagnosis in adjunct with the clinical context Chiropractor Indicators and monitoring treatment Advices for Lifestyle and exercises and monitoring Advices for Lifestyle and exercises and monitoring Advices for Lifestyle and exercises and monitoring Exercises Sport men condition Evaluation and improvement Statistical risk analysis • No access before 5 measurements. The accuracy increased with the number of measurements. • Statistical analysis of the indicators of each body systems and metabolic general indicators • It is not a diagnosis , but help for the physician in the process of elimination