noninvasive blood pressure measurement

1. noninvasive blood pressure measurement

2. OPT oscillometric pressure telemetry a novel way to measure non-invasive blood pressure in freely moving dogs based on well proven oscillometric cuff method implemented by miniaturized hardware components suitable for telemetry analyzed using proprietary detection algorithm

3. emkaPACK with ecg electrodes and OPT cuff the OPT add-on fits within the standard emkaPACK transmitter case the pump and other electronic components run on the same AA batteries used for standard emkaPACK transmitter

4. setting up the animal tail is shaved cuff is wrapped around the tail and connected to the transmitter a custom velcro extension protects the cuff, and maintains it in the proper position on the tail

5. how does it work? runs in user programmed series of cycles during one cycle cuff pressure rises rapidly to fully inflate the cuff cuff pressure is slowly released OPTtrain programming graph

6. 20 mn of cuff pressure signal with 5 inflation cycles

7. close up of inflation cycle

8. frequently heard objections the dog will not tolerate a cuff on its tail the system has been used for 1000 hours on more than 40 dogs from multiple colonies the cuff was never chewed off connecting tubes from the cuff to the transmitter were chewed off 3 times: improvements in the protective cloth prevented recurrence

9. frequently heard objections the dog startles and wakes up at each inflation cycle some dogs may startle the first couple of times the system inflates but all acclimate in a matter of minutes numerous video recordings prove that dogs, either awake or asleep, do not react when cuff inflates

10. still shots from video recordings

11. ecg, activity, cuff pressure traces dog movement with its effect on ecg is clearly visible on the activity trace cuff inflation triggers no reaction from the dog

12. ecg, activity, cuff pressure traces cuff inflation cycle triggers no reaction from sleeping dog

13. frequently heard objections measurements are lost whenever the dog moves yes, if a dog is very agitated or vigorously wags its tail, there are losses in signal quality however marked agitation only occurs a small percentage of the time during a 24 hour acquisition the analysis algorithm automatically discards cycles too noisy to provide reliable analysis spurious results are automatically invalidated

14. frequently heard objections this measurement method is unreliable! OPT provides reliable results under stable conditions and detects changes when they occur potential users say that they are aware of potential limitations but that obtaining this measurement would be of great value

15. mean blood pressure and heart rate from a conscious freely moving dog (20 hour acquisition; each data point corresponds to one inflation cycle)

16. how is analysis performed? detects inflation cycles applies hi-pass filter selects valid blood pressure pulses produces bell shaped amplitude curve computes mean, systolic and diastolic pressure values

17. what are the challenges to produce a reliable analysis? signal is not always as clean as on previous picture when signal is noisy the algorithm picks pulses that correspond to blood pressure beats and ignores artefacts for greater efficiency, the software applies a number of criteria and rejects unreliable or spurious results

18. when things get rough… as on second picture, software ignores pulses from noisy zone

19. why is analysis able to provide reliable results? we use innovative processing methods to automatically reject data which does not correspond to heart beat pressure pulses user is able to review and edit beat by beat data what level of analysis can be obtained? present experience (around 1000 hours of data from 60 dogs) indicate that from 70 to 95% of inflation cycles produce reliable data

20. results of a comparative test study 4 dogs 12 hour acquisition one OPT measurement every 5 minutes prazosin administration at t=0 by gavage (0.1mg/kg) comparison with data from DSITM implant this study as well as numerous preliminary trials of the system, were performed at CIT, a CRO in the Paris area

21. results of a comparative test study DSITM data recorded through openArt and Notocord HEM analyzed with HEM data reduction with Excel macros from CIT emka TECHNOLOGIES data recorded with emkaTECHNOLOGIES’ iox analyzed with nibp module from emka TECHNOLOGIES’ ecgAUTO data reduction with emka TECHNOLOGIES’ datanalyst at equivalent points

22. results of a comparative test study systolic, mean and diastolic blood pressure following vehicle treatment (N = 4): circles = emka TECHNOLOGIES OPT, squares = DSITM)

23. results of a comparative test study systolic, mean and diastolic blood pressure following Prazosin treatment (N = 4): circles = emka TECHNOLOGIES OPT, squares = DSITM)

24. results of a comparative test study systolic, mean and diastolic blood pressure following vehicle treatment (N = 4): circles = emka TECHNOLOGIES OPT, squares = DSITM)

25. results of a comparative test study systolic, mean and diastolic blood pressure following Prazosin treatment (N = 4): circles = emka TECHNOLOGIES OPT, squares = DSITM)

26. test on cynomolgus monkey data was acquired for 20 hours on a monkey the animal had not been acclimated prior to the recording the animal tolerated the cuff some extra protection was applied to the cuff pulse amplitude was smaller than from the dog data analysis produced pressure data consistent with other parameters, including heart rate and activity

27. test on cynomolgus monkey courtesy INA Reasearch, Japan systolic and mean blood pressure, HR and pulse transit time (12 out of 400 data points were manually removed as spurious data)

28. test on cynomolgus monkey cuff pressure cycle and XY plot of individual blood pressure pulses

29. parallel measurement on dog with NIBP & VAP (vascular access port) courtesy of Zhejiang Univ., China 20mn average of mean pressure from NIBP recording protocol with Prazosin treatment mark beat by beat mean pressure from vap (color density display)

30. why do we think OPT is superior to previous systems? OPT acquires pressure on freely moving animals users see recorded data as well as how data is processed and analyzed - this is available on-line and in post-processing mode users may edit analysis results, and discard outliers OPT is the only system specifically tailored to safety pharmacology and toxicology needs OPT may, of course, also acquire data from restrained animals

31. OPT snapshot • designed for the specific needs of snapshot measurements on restrained animals • uses the same technology, data format, and software as ambulatory OPT • measures: • NIBP • 1 to 7 lead ecg • provides a seamless solution for safety pharmacology and toxicology • available in summer 2010

32. OPT is the only noninvasive blood pressure measurement for ambulatory animals has proven its validity through initial trials & test studies is a viable complement to implantable telemetry has very low recurring costs is available as an optional add-on to the fully validated emkaPACKproduct line is specifically designed for safety and tox studies

33. website visit our websites for complete product descriptions, case studies, a knowledge base, & frequently asked questions: www.emka.fr & telemetry.emka.fr

34. contact us! please contact us to see how we can help you meet your telemetry research goals! whatever the scale and complexity of your project, please contact us for a professional, competitively priced solutions adapted to your needs  emka TECHNOLOGIES S.A. 59, bd. général Martial Valin - 75015 Paris - FRANCE phone: +33 (0)1 40 60 76 00 fax: +33 (0)1 40 60 65 66 sales and support office for North America: emka TECHNOLOGIES Inc. 307 Annandale Road, suite 203 Falls Church, VA 22042 - USA phone: +1 (703) 237-9001 fax: +1 (703) 237-9006 for all inquiries contact : sales@emka.fr distributor for China: Beijing GuangYuanDa Science and Technology Co. Ltd. Suite 305 Hongchen Business Center,No 20 ZhongFangLi, Chaoyang District, Beijing 100020 phone: +86-10-65019453 fax: +86-10-65019453 contact: information@bjgyd.com distributor for Japan: Physio-Tech Co., Ltd 6-3, Iwamoto Cho 1-Chome Chiyoda-Ku, Tokyo 101-0032 +81 3 3864 2781 +81 3 3864 2787 contact: emka@physio-tech.co.jp Physio-Tech website: www.physio-tech.co.jp