Glossary

Term Definition
A
ABI Ankle Brachial Index
AIPTG A measure of systemic arterial stiffness derived from the ascending aortic pressure waveform. AIPTG is a marker of the LDL cholesterol level. Normal <= 0.45
ANS The Autonomic Nervous System which is responsible for the control of bodily functions not consciously directed, such as breathing, heartbeat, and digestive processes.
ANS1 CMR Stands for ANS1 Cardiometabolic Risk Score in percent with a scale of 0 to 100%.
ANSa Score Stands for Autonomic Nervous System Activity Score and is shown in percent with a scale of 0 to 100%.
ANSb Score Stands for the Autonomic Nervous System Balance Score at Baseline and is represented in percent with a scale of 0 to 100%.
ANSD ANS Dysfunction is based on heart rate variability (HRV) analysis at rest and it comprises ANS activity and the balance of sympathetic and parasympathetic systems.
ANSD R ANS Dysfunction Risk is represented by a scale of 0 to 100%.
ANSR ANS Risk provides the data for detection of small ber neuropathy (see below).
ANS CMR ANS Cardiometabolic Risk is represented by a score in percent with a scale of 0 to 100%.
C
CAN Cardiac Autonomic Neuropathy is a risk marker for mortality and cardiovascular morbidity, and possibility a progression promoter of diabetic neuropathy. In addition, CAN increases the risk of hypoglycemia in diabetic patients undergoing treatment.
CAN R Cardiac Autonomic Neuropathy Risk is assessed from the seven autonomic cardiovascular indices recommended by the Cardiac Autonomic Neuropathy Subcommittee of the Toronto Consensus Panel on Diabetic Neuropathy. It is represented in a percent from 0 to 100%.
CIs Cardiac Index is an indicator that relates the cardiac output (CO) to body surface area (BSA). Normal >=2.8 L/min/m2
CMR Various markers of the exam determine Cardiometabolic Risk Score. At 120 minutes, the co-efficient of correlation between the OGTT and CMR score was r=0.56 (p=0.004) for glucose, r=0.53 (p=0.006) for insulin, and r=0.58 (p=0.002) for C-peptide. Based on a clinical study comparing diabetes patients to healthy controls, CMR score had a sensitivity of 91.7% and specificity of 80% as marker for diabetes.
D
DPRS Diastolic Pressure Response to Standing is the difference between the sittings diastolic minus the standing diastolic pressure. Normal <=5 – >=10 mmHg
Diastolic P Refers to the pressure of the blood in the artery when the heart relaxes. Normal <=90 mmHg
E
E /I R Expiration and Inspiration Ratio is calculated by the longest RR Interval divided the shorter RR Interval during the deep breathing test. It reflects parasympathetic systems cardiovagal response to a challenge.
EndoD Endothelial Dysfunction is the earliest clinically detectable stage of cardiovascular disease EndoD is determined by photoplethysmography analysis.
EndoT Score Endothelial Dysfunction is the earliest clinically detectable stage of cardiovascular disease. The score is measured in percent from 0 to 100%.
ESR L Electrical Skin Response Latency is a marker of sweat gland nerve density. This marker reflects post sympathetic nerve density. The peak reflects C- ber density. Low numbers are an early detection of peripheral distal neuropathy. Normal <=2 Sec
ESR NO Electrical Skin Response Nitric Oxide is a marker that reflects microcirculation blood ow and increased risk of distal neuropathy. Normal >=52 μ Si
H
HF High Frequency is an indicator of the parasympathetic system. Normal >=220 ms2
Homeo Score Homeostasis Score comprises the PTG Spectral Analysis main markers. Studies showed the homeo score had a sensitivity of 84.6% and a specificity of 98% to detect patients with atherosclerosis. It is measured in percent from 0 to 100%.
HR Heart Rate per minute is calculated from the second derivative of the oximeter waveform. Normal <=90 bpm
I
IR Insulin Resistance is a strong risk factor of impaired glucose tolerance (IGT), type 2 diabetes (T2DM) and cardiovascular diseases. Studies show that Metformin treatment or lifestyle changes could reverse it. Comparing our PTG TP marker vs. the HE Clamp, our marker has a sensitivity of 90% and specificity of 90% to detect M value < 4.5 (P.0.0001) and therefore insulin resistance.
K
K30/15 Evaluates the change in heart rate in the standing position. It reflects the parasympathetic system cardiovagal response to the change of posture. It is considered an index of cardiovascular function. Normal >=1.1
L
LF/HF Low Frequency/High Frequency is a marker for ANS and mental stress. A value >2 indicate mental stress.
LVETi Left Ventricle Ejection Time Index is adjusted with the heart rate.
P
Parasympathetic Nervous System This is part of the involuntary autonomic nervous system that is responsible for slowing the heart rate, increasing intestinal and glandular activity, and relaxes the sphincter muscles. The parasympathetic along with the sympathetic nervous system make up the ANS.
Peak C Peak C is a marker of sweat gland function and reflects maximum number of water and chlorine released on the electrode plate after stimulation. Decreased Peak C
is either due to nerve damage or hypohidrosis (low sweat). An abnormal number (high or low) can be attributed to hyperhidrosis (excessive sweat). Low numbers
are found with nerve damage. Normal >=90 μ Si
PEP Stands for the Pre-Ejection Period. Studies have shown that PEP is inversely correlated with left ventricle contractibility. Normal <= 110 ms
PEPi/LVETi Pre-Ejection Period index/Left Ventricle Ejection Time index ratio has been shown in studies to correlate to cardiac performance. Normal = 0.35
pNN50 An indicator of the heart rhythm stability. Normal >=10%
Power HF An indicator of the parasympathetic or vagal activity in the area of the spectral analysis. Normal >=220 ms2
Power HF nu An indicator of the parasympathetic or vagal activity expressed as percent of the total power. Normal >=22%
Power LF nu An indicator of both sympathetic and parasympathetic systems expressed as percent of the total power. Normal <=46%
Power LF An indicator of both sympathetic and parasympathetic systems expressed in area of the spectral analysis. Normal >=220 ms2
PTF Score Parasympathetic Test Failure Score is important because parasympathetic failure could increase cardiovascular events; and it is an indicator of CAN. It could also be associated with symptoms of dizziness or orthostatic hypotension. It is measured in percent from 0 to 100%.
PTG CVD The Photoplethysmography Cardiovascular Disease risk is based on the homeostatic markers issued from the PTG spectral analysis (PTGi, PTGVLFi, and PTGr). Our studies demonstrate that PTGi, PTGVLFi and PTGr are respectfully correlated to endothelial dysfunction, autonomic dysfunction and artery blood ow. Endothelial dysfunction, ANS dysfunction, and artery blood ow are known risk factors for atherosclerosis, and our study showed the PTG CVD score had a sensitivity of 82.5% and specificity of 96.8%, at a cuto of 2, when used to detect Coronary Artery Disease (CAD).

If above is in the yellow or orange range, generally look at performing an Ankle Brachial Index (ABI) or other acceptable device for verification and edification. As always, this decision is based on physician’s determination of Medical Necessity.

PTG CVD R This stands for risk score in percent with a scale of 0 to 100%.
PTG I The Photoplethysmography Index of the Spectral Analysis Components has been shown in studies to detect endothelial dysfunction and has a specificity of 88%
and sensitivity of 86% . At the 120 minute assessment of the OGTT, the correlation between glucose and PTG i r=minus 0.56, p=0.003. Normal >=40 Vs
PTG R The Photoplethysmography Ratio is calculated from the Spectral Analysis Components (PTGVLF/PTGi). Normal <=21%
PTGLF Plethysmograph – Very Low Frequency has been shown in studies to be inversely correlated with arterial blood ow. Normal <=100 ms2
PTGVLFi Photoplethsmography – Very Low Frequency Index is an algorithm calculated from PTGVLF and adjusted with a sudomotor marker (Baseline). Studies show that PTGVLFi has a specificity of 88% and a sensitivity of 92% comparing diabetic patients and control group. Normal <=33 ms2/μ Si
R
RI Reflection Index is an indicator of stiffness of the small and medium arteries of the circulatory system and is a marker for atherosclerosis. Normal <=45%
RMSSD The Root Mean Square of the Successive Differences is an indicator of parasympathetic activity and re ects the electrical stability of the heart. Normal >=35 ms
RR Intervals The intervals between each heartbeat. Normal >= 670 ms
S
SD ba Standard Deviation Baseline is taken from the height of the 2nd point of the 2nd derivative of the original waveform (Acceleration Algorithm). Studies have shown that SD ba has a good correlation with Framingham Risk Score. Normal <=0.95
SD da Standard Deviation Data is taken from the height of the 4th point of the 2nd derivative of the original waveform (Acceleration Algorithm). Studies have shown that SD da has a good correlation of angiotensin activity. Normal <=0.42
SDNN Standard Deviation of Normal-to-Normal intervals is calculated by the square root of the variance. SDNN should be an indicator of both sympathetic and parasympathetic regulation and as a marker of VO2 (measure of the volume of oxygen used by the body) maximum in patients not undergoing any treatment. Normal >=40 ms
SFN Small Fiber Neuropathy is assessed through the ANSR score. SudoD score is based on decreased results and reflects the reduction of activated sweat gland density. However, a low score of SudoD based on increased results could be a sign of small fiber inflammation in elderly patients and could provide the same symptoms. Based on the clinical study comparing the diabetes subgroups with Diabetic Neuropathy Symptoms (DNS) Score >=1 and the diabetes patients group with DNS Score =0, SMR. Score had a sensitivity of 91.4% and specificity of 79.1% to detect DNS>=1 in diabetic patients (P=0.0001).
SpO2% Peripheral Capillary Oxygen Saturation shows the percentage of oxygen saturation in the hemoglobin. Normal >95%
SPRS Systolic Pressure Response to Standing is the difference between the sitting systolic pressure minus the standing systolic pressure. Normal <=10 – >10 mmHg
STA Score Sympathetic Test Assessment Score assesses the sympathetic response, which could increase cardiovascular events. Sympathetic failure is an indicator of CAN. It is measures in percent from 0 to 100%.
SPRV2 Systolic Pressure Response to the Valsalva maneuver in phase 2. SPRV2 is correlated with norepinephrine response. Normal <20 – >40 mmHg
STRESS I Stress Index reflects the sympathetic system activation, which may increase the hepatic glycolysis and hepatic insulin resistance. Stress I has a sensitivity of 94.5% and specificity of 31.8% comparing diabetic patients and control group. Normal <=180%
SudoD Sudomotor Dysfunction is defined as decreased sudomotor activity. SudoD is the earliest clinically detectable sign of autonomic neuropathy in populations at high risk, such as diabetic patients.
Sympathetic Nervous System The part of the ANS that contains chiefly adrenergic fibers and tends to depress secretion, decrease the tone and contractility of smooth muscle(s), and increase heart rate.
Systolic P This refers to the pressure of the blood in the artery when the heart contracts. Normal <=140 mmHg
T
T. Power Total Power is the main indicator of the ANS activity. The TP is also used in peer reviews to de ne the total Heart Rate Variability (HRV) score. Normal >=780 ms2
V
Vals. R Valsalva Ratio identifies subsequent tachycardia / bradycardia during the Valsalva maneuver which are baroreceptor mediated. Normal >=1.18
VO2 A measure of the Volume of Oxygen used by the body.

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