Method and device for monitoring and improving arteriogenesis

Abstract

A method for determining an arteriovascular condition of a subject having an arterial blood flow is shown. The method involves determining a temporal progression of an instantaneous blood flow condition of the arterial blood flow as well as deriving a slew rate of the temporal progression during an increase of the temporal progression. In addition, an arteriovascular condition indicator device is shown, which comprises: an input for receiving an input signal representing an instantaneous arterial blood flow condition of a subject and a slew rate monitor connected to the input. A corresponding control device for providing an activation signal is also shown. The control device comprises a maximum detector connected to the slew rate monitor. A method for stimulation of arteriogenesis is also shown, wherein a temporal progression of an instantaneous blood flow condition is monitored, a slew rate of the temporal progression is derived, and the maximum of the slew rate is determined. An external pressure is applied repeatedly to the arteriovascular section in synchronization with the occurrence of the determined maximum.

1 - 21 . (canceled) 
     
     
         22 . A system for stimulation of arteriogenesis in a subject, comprising
 a sensor device measuring a heartbeat of the subject and providing respective measuring signals of the heartbeat of the subject;   a control device providing an activation signal based upon the measuring signals provided by the sensor device; and   an actuator device comprising an actuator surface for moving the same in correlation with a point of time based on the measuring signals of the heartbeat of the subject, wherein the actuator device is controlled by the activation signal provided by the control device for initializing application of external pressure repeatedly to an arteriovascular section or tissue of the subject.   
     
     
         23 . The system of  claim 22 , wherein the actuator device applies external pressure repeatedly to the arteriovascular section or tissue of the subject during a diastole of the heartbeat of the subject. 
     
     
         24 . The system of  claim 22 , wherein the application of pressure is initialized a predefined time after a predetermined point during the systole of the subject, corresponding to a phase shift between the predetermined point and the application of pressure to the arteriovascular section or tissue of the subject. 
     
     
         25 . The system of  claim 22 , wherein the sensor device is an electrocardiogram device comprising ECG-sensing electrodes. 
     
     
         26 . The system of  claim 22 , wherein the measuring signal is an electrocardiogram signal. 
     
     
         27 . The system of  claim 22 , wherein the actuator device is an extemal counterpulsation (ECP) device. 
     
     
         28 . The system of  claim 24 , wherein the predetermined point during the systole of the heartbeat of the subject is a maximum slew rate of a temporal progression of an instantaneous arterial blood flow condition during a systole of the heartbeat of the subject. 
     
     
         29 . The system of  claim 28 , wherein the actuator device, during a diastole of the heartbeat of the subject, applies external pressure to the arteriovascular section or tissue of the subject based on the activation signal from the control device. 
     
     
         30 . The system of  claim 29 , wherein the actuator device applies external pressure to the arteriovascular section or tissue of the subject a predefined time after the occurrence of the maximum slew rate during a systole of the heartbeat of the subject, corresponding to a phase shift between the detection of the maximum slew rate of this systole and the application of pressure during a following diastole of the heartbeat of the subject. 
     
     
         31 . The system of  claim 22 , wherein the measuring signals of the heartbeat of the subject are used to determine a temporal progression of an instantaneous arterial blood flow condition of the subject within the heart of the subject. 
     
     
         32 . The system of  claim 31 , wherein the control device determines a maximum of a slew rate of the instantaneous arterial blood flow condition's temporal progression during a diastole of the heartbeat of the subject as basis for the activation signal. 
     
     
         33 . The system of  claim 32 , wherein the maximum of the slew rate corresponds to (a) the maximum slew rate of the instantaneous blood flow velocity, (b) the maximum slew rate of the instantaneous fluid pressure, (c) the maximum slew rate of the instantaneous shearing force, or (d) one of these maximum slew rates normalized by a mean value of the blood flow velocity, of the fluid pressure or of the shearing force or (e) one of these slew rates normalized by the ratio of the mean value of the blood flow velocity, of the fluid pressure or of the shearing force to the cross sectional diameter of the arteriovascular section or to a fraction thereof. 
     
     
         34 . The system of  claim 22 , wherein the control device uses a point of time of a maximum of a slew rate of the instantaneous arterial blood flow condition's temporal progression for providing the activation signal during a diastole of the heartbeat of the subject. 
     
     
         35 . The system of  claim 34 , wherein the actuator device applies external pressure to the arteriovascular section or tissue of the subject a predefined time after occurrence of the maximum slew rate, corresponding to a phase shift between the detection of the maximum slew rate and the application of pressure during a diastole of the heartbeat of the subject. 
     
     
         36 . The system of  claim 22 , wherein the application of pressure by the actuator device is synchronized with a point of time of a maximum slew rate of the temporal progression of an instantaneous arterial blood flow condition during a systole of the heartbeat of the subject based on the measuring signals provided by the sensor device. 
     
     
         37 . The system of  claim 22 , wherein the control device, based on the measuring signals provided by the sensor device, determines a maximum shearing force increase normalized by a mean value of the shearing rate in the form of a relative peak shear increase (RPSI) during a diastole of the heartbeat of the subject as basis for the activation signal. 
     
     
         38 . The system of  claim 22 , wherein the stimulation of arteriogenesis is achieved by enhancing the arteriogenic capacity of the arteriovascular section or tissue of the subject by means of applying pressure thereto during a diastole. 
     
     
         39 . The system of  claim 22 , wherein the control device comprises
 an input for receiving the measuring signals from the sensor device, wherein the measuring signals are used by the control device as basis for determining a temporal progression of an instantaneous arterial blood flow condition of the subject;   a slew rate monitor relating variations of the blood flow condition to a distance of time spanned by the variation, the slew rate monitor providing a slew rate representing the variations;   a maximum detector connected to the slew rate monitor for receiving the slew rate, the maximum detector being suited to identify a point of time at which the maximum slew rate occurs, and   an output element to provide an activation signal synchronized to the point of time of the maximum slew rate upon receipt of the signal provided by maximum detector.   
     
     
         40 . The system of  claim 39 , wherein the actuator device applies external pressure to the arteriovascular section or tissue of the subject a predefined time after occurrence of the maximum slew rate based on the activation signal provided by the output element. 
     
     
         41 . The system of  claim 40 , wherein the actuator device further comprises an actuator element connected to the activation signal and adapted to move the actuator surface in response to the activation signal from the output element.