By the 18th of May 2022 Neuromon BV has released its CardiovascularSimulation App on the AppStore for MacOS. This app simulates the small and large circulation in the body and offers different scenario's to demonstrate changes herein. Also, different therapeutic interventions may be selected to counter-act pathophysiological changes in blood supply to the brain.
The app was developed for medical experts only.
Compumedics DWL® has recently released an update of the Transcranial Doppler QL software V 3.6.8 . This update incorporates Z-score analysis of middle cerebral artery flow velocity within the NMA module.
A Z-score expresses how many standard deviations a given middle cerebral artery flow velocity measurement lies above or below the value expected for that age. Z-scores of different variables (Sys1, Sys2, D560 and HR) can be combined into a single radar plot to facilitate the rapid interpretation of intracranial hemodynamics in health and disease.
The theory of arterial acceleration is a fundamentally new view on how the cardiovascular system promotes oxygen enriched blood to reach all the bodies capillary systems. It also provides a new perspective on pulsatile signals such as the arterial blood pressure, measured invasively or non-invasively, and blood flow (velocities) in the brain or elsewhere in the body. The theory of arterial acceleration proposes that systole consists of two phases, the first being the result of a short-lasting stiffening of the smooth muscle layers in the arterial tree, the second being the result of stroke volume being ejected into the aorta and large capacitance arteries.
Neuromon BV strives to popularise the theory of arterial acceleration since it is expected that this novel approach to signal interpretation will katalyse new insights in cardio-vascular (patho-)physiology and, thus, therapy. More knowledge of the theory of arterial acceleration seems most relevant for ICU-specialists since they carry the daily responsibility for severely ill patients on the ICU.
Apart from educational video's to be found on the internet Neuromon also offers an interactive education course via videoconferencing. This course consists of 6 modules:
1. introduction to the course; introduction to transcranial Doppler
2. introduction to the measurement of arterial blood pressure; the CNS ischemic response
3. current theories on wave form characteristics; theory of arterial acceleration
4. TCD monitoring; effect of ageing on pulsatile signals
5. baroceptor and chemoceptor reflex; model for cardiovascular simulation
6. clinical cases such as carotid stenosis and sepsis; history of conceptual thinking about arterial blood pressure
The modules have a duration of approximately 30 min. each and will be presented online on a weekly basis. Each module will end with approximately 15 minutes of discussion. The subscription for the full course amounts Euro 200. After actively participating in all six modules, you will receive a formal certificate testifying your participation.
Have you ever wondered why intracranial pressure elevation (ICP) is accompanied by systolic spikes in the middle cerebral artery flow velocity signal?
Model simulation shows that the penetration force of arterial acceleration (a brief arterial stiffening at stroke onset) overcomes ICP, whereas later phases of systole (ejection phase) and diastole do not. The video of the model simulation shows how systolic spikes prevail when ICP is gradually increasing.
In the simulation above the intracranial pressure is gradually increased. Notice the simulated waveform of middle cerebral artery flow velocity: blue curve at the right (red curve is simulated arterial blood pressure).