1. ACRIN CV Committee Arterial Tonometry Preston Broderick, MA University of Pennsylvania

2. ACRIN CV Committee Arterial Tonometry  Non-invasive device used to obtain Pulse Wave Analysis (PWA), Pulse Wave Velocity (PWV)  To be performed immediately after the MRI  ~30 minute procedure  Participant must be laying down  Do not include PHI in the database

3. ACRIN CV Committee Arterial Tonometry Adding a subject to the database

4. ACRIN CV Committee Arterial Tonometry  Information that must be entered  ID  First Initial  Last Initial  Year of Birth  Sex

5. ACRIN CV Committee Arterial Tonometry

6. ACRIN CV Committee Arterial Tonometry  Pulse Wave Analysis  Obtain BP measurements using an Omron HEM-907 device  Use that data to calculate the mean arterial pressure with the following equation: MAP = DBP + 0.4 (SBP-DBP)  Type the sbp in the notes section as “SBP: x”  Indicate which side the radial tonometry is being performed in the notes section  Enter data into PWA subject screen as follows

7. ACRIN CV Committee Arterial Tonometry Pulse Wave Analysis (Radial)

8. ACRIN CV Committee  Data acquisition  Relax your arms and hands  Maintain a constant pressure  Acquire 12 seconds of data  Complete acquisition by pressing the space bar  Goal is to achieve good consistency and height in the waveforms  Shoot for as high an operating index as possible Ideal target: >90 for radial Ideal target: >80 for carotid Arterial Tonometry

9. ACRIN CV Committee Arterial Tonometry 12 Seconds of consistent data acquisition

10. ACRIN CV Committee Arterial Tonometry Favorable Result: 94 Operator Index

11. ACRIN CV Committee Arterial Tonometry Unfavorable Result: 0 Operator Index

12. ACRIN CV Committee Arterial Tonometry Pulse Wave Analysis (Carotid)

13. ACRIN CV Committee Arterial Tonometry Pulse Wave Analysis (Carotid)

14. ACRIN CV Committee Arterial Tonometry 12 Seconds of consistent data acquisition

15. ACRIN CV Committee Arterial Tonometry Favorable Result: 95 Operator Index

16. ACRIN CV Committee Arterial Tonometry Unfavorable Result: 5 Operator Index

17. ACRIN CV Committee Arterial Tonometry  Pulse Wave Velocity  Measure distance (mm) between carotid artery and sternal notch  Measure distance (mm) between femoral artery and sternal notch  Shoot for lowest standard deviation possible Ideal target <10% SD  Place ECG electrodes on subject prior to acquisition

18. ACRIN CV Committee Arterial Tonometry Pulse Wave Velocity

19. ACRIN CV Committee Arterial Tonometry Pulse Wave Velocity (Carotid) 12 Seconds of consistent data acquisition

20. ACRIN CV Committee Arterial Tonometry Pulse Wave Velocity

21. ACRIN CV Committee Arterial Tonometry Pulse Wave Velocity (Femoral) 12 Seconds of consistent data acquisition

22. ACRIN CV Committee Arterial Tonometry Favorable Result: 7% SD

23. ACRIN CV Committee Arterial Tonometry Unfavorable Result: 13% SD

24. ACRIN CV Committee Arterial Tonometry  Exporting data from software  This is the data that will be used for analysis  Export text file after each study visit  Three exports for each visit PWA Radial PWA Carotid PWV  Choose result with highest operator index to export  Keep organized by subject ID, visit number, and result 001_B_PWAR 001_B_PWAC 001_F_PWV

25. ACRIN CV Committee Data Export Arterial Tonometry

26. ACRIN CV Committee Arterial Tonometry Data Export

27. ACRIN CV Committee Arterial Tonometry Data Export

28. ACRIN CV Committee Arterial Tonometry Data Export

29. ACRIN CV Committee Arterial Tonometry  Backing up the database  Imperative in case of data loss  Backup text files as well as database file  Database file located in following location:  C:\Program Files\AtCor\SphygmoCor CvMS\data  Filename: scor.xyz  Simply copy/paste file into a location other than C:\ drive  Backup database as frequently as possible  Rename database file to date it was backed up  Example: scor4008_5-23-2013.xyz