SUMMARY REPORT. Autonomic Nervous System Function. Valsalva 100

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1 SUMMARY REPORT Nervous System Function 8 Heart Rate (red) & Blood Pressure (blue) Parasympathetic Balance Sympathetic hypertonia 4 [bpm] Resting Deep Breathing Valsalva Standing Relaxation Balance Stress. Sympathetic (LFa). Sympathetic (LFa). Sympathetic (LFa). Sympathetic (LFa) Sympathetic Vagal HR BP LFa HFa SpO2 Comment Resting 82 28/ Borderline normal level of sympathetic and parasympathetic tone; Deep 89 7/ Normal Parasympathetic to stimulation; Breathing 7 Valsalva 9 32/ Normal Sympathetic to stimulation; Standing 95 25/ Normal ANS to stimulation; Enhanced cardiovascular adaptation. The autonomic regulation of the functioning of the cardiovascular system provides enormous ability for a long-term adaptation to physical exertions and to adequately tolerate them. Typically this is a sign of the absence of physical exhaustion, overtraining or any cardiovascular health conditions. This is a typical pattern of a physically active healthy individual without any evident signs of physical exhaustion, overtraining or other conditions altering the regulatory functions of the autonomic nervous system or a cardiovascular to it; Activity 68 ms2 4-8 Valsalva Ratio.25 ratio >.5 Balance 2.3 ratio :5 Ratio.26 ratio >. E/I Ratio.5 ratio >. Functional Age 56 years < 53 Score Norms Description Comments MSI -.88 <. MSI is an indicator of accumulative mental stress. Mental stress can be caused by situations one has to cope with daily and the emotional states that result. The way in which a person copes with stressful events is a significant contributing factor to this process When the stress becomes too great the body will show PSI. <. PSI is an indicator of accumulative chronic physical stress. Physical stress can be caused by long-term exposure to negative factors in one`s life or physical illness. The way in which a person copes with physical stressors is a significant contributing factor to this process When the stress becomes too great the body Cardiovascular Function Score Norms Description Comments EEI EEI is an indicator for left ventricle ejection power and elasticity of large arteries. Borderline Normal Blood Circulation DDI DDI indicates the contractility, tension and stiffness in the small arteries. Borderline Normal Blood Circulation DEI DEI represents the reflection of arterial elasticity and blood flow in the venous system. Normal Blood Circulation The score is below average. It indicates low mental stress. Stress in the recent past has had little effect on your mental-health. The negative effects of mental stress are limited. The score is clearly above average. It indicates high physical stress. Stress in the recent past has had a major impact on your physical balance. The negative effects of physical stress are clearly visible. It is possible that you experience physical inconveniences as myalgia, back complaints, palpitations and reduced resistance to illness. AI -.28 < -.7 Augmentation Index (AI) is a useful marker for cardiac risk. AI increases with age and a AI is a measure of arterial stiffness and it provides general information about the arteries. AI is sedentary lifestyle. positively correlated with pulsewave velocity, blood pressure and hypertension. ABI Ankle/Brachial Index Acceptable, Borderline TBI.5 >.75 Toe/Brachial Index Normal range Reflection Index Cardiac Output 5.29 l/min C 2.8 ml/mmhg >. Ventricular Extrasystole < QRS 53 ms 6-2 Stiffness Index 8.55 m/s < 8. Mean Arterial Pressure 88 mmhg 7- C ml/mmhg > 6. Atrial Extrasystole < QTc 355 ms Sudomotor Function Stroke Volume 64.6 ml 55- Blood Volume 5.25 l 3-5 DPTI/SPTI.26 ratio Artifacts < Body Mass Index Score Norms Description Comments Sudomotor Neuropathy 4 < 5 Risk for sudomotor autonomic neuropathy. Sweat Gland C-Fiber density and function Printed: 9 May 28 2:8

2 CARDIAC AUTONOMIC NEUROPATHY ASSESSMENT 5 AUTONOMIC ACTIVITY AUTONOMIC BALANCE - Sympathetic Balance Parasympathetic The sympathetic nervous system activates the fight-or-flight s. It activates the glands and organs that defend the body against attack. The sympathetic nervous system uses up energy and depletes the body.the parasympathetic nervous system controls the rest and digest s. The parasympathetic nervous system, when activated by rest, relaxation and happy thoughts, is essential for balanced living and for all healing Parasympathetic Balance Sympathetic Relaxation Sympathetic hypertonia Balance Stress Vagal E/I RATIO:.5 Expiration/Inspiration Ratio is a marker of cardiovagal VALSALVA RATIO:.25 Marker of baroreceptor sensitivity /5 RATIO:.26 Heart rate change during standing or tilt at 3 and 5 second Systolic Pressure Response to Standing: Marker of sympathetic adrenergic function. 4 mmhg Nervous System Borderline normal level of sympathetic and parasympathetic tone; Parasympathetic Response to Deep Breathing Normal Parasympathetic to stimulation; Sympathetic Response to Valsalva Maneuver Normal Sympathetic to stimulation; Active Standing Normal ANS to stimulation; Enhanced cardiovascular adaptation. The autonomic regulation of the functioning of the cardiovascular system provides enormous ability for a long-term adaptation to physical exertions and to adequately tolerate them. Typically this is a sign of the absence of physical exhaustion, overtraining or any cardiovascular health conditions. This is a typical pattern of a physically active healthy individual without any evident signs of physical exhaustion, overtraining or other conditions altering the regulatory functions of the autonomic nervous system or a cardiovascular to it; Printed: 9 May 28 2:8

3 AUTONOMIC REGULATION ASSESSMENT AUTONOMIC PHYSICAL DYSREGULATION (PSI) =. PSI is an indicator of accumulative chronic physical stress. Physical stress can be caused by long-term exposure to negative factors in one`s life or physical illness. The way in which a person copes with physical stressors is a significant contributing factor to this process. When the stress becomes too great, the body will show signs of distress. ACCUMULATIVE MENTAL STRESS (MSI) = -.88 MSI is an indicator of accumulative mental stress. Mental stress can be caused by situations one has to cope with daily and the emotional states that result. The way in which a person copes with stressful events is a significant contributing factor to this process. When the stress becomes too great, the body will show signs of distress. A A B B C C C C D E F F The score is clearly above average. It indicates high physical stress. Stress in the recent past has had a major impact on your physical balance. The negative effects of physical stress are clearly visible. It is possible that you experience physical inconveniences as myalgia, back complaints, palpitations and reduced resistance to illness. A A B B C C C C D E F F The score is below average. It indicates low mental stress. Stress in the recent past has had little effect on your mental-health. The negative effects of mental stress are limited. Balance: 2.3 Borderline normal level of sympathetic and parasympathetic tone; The sympathetic nervous system activates the fight-or-flight s. The parasympathetic nervous system controls the rest and digest s. Total Activity: 68 Maker of the overall ANS activity at rest Body Mass Index (BMI): 27 Overweight - prone to health risks Body mass index is defined as the individual's body weight divided by the square of his or her height. The body mass index can be used to identify if you are overweight. Parasympathetic Balance Sympathetic LFa.38 ms2.5-4 HFa 2.7 ms2.5-4 Blood Pressure 28/7 mmhg <2 SpO2 97 % >94 BPSys Response to Standing 4 mmhg < Functional Age 56 years < 53 Health Risk Factor 45 % < 5 SDNN 28 ms > 4 HeartRate 82 bpm < 9 Ventricular Extrasystole < Atrial Extrasystole < Artifacts < A - Normal B - Borderline Normal C - Moderate D - Borderline Abnormal E - Abnormal F - Severe Relaxation Sympathetic hypertonia Balance Stress Vagal 8 Heart Rate (red) & Blood Pressure (blue) 4 [bpm] 3 6 [s].79 ECG -.79 [mv] Printed: 9 May 28 2:8

4 PERIPHERAL ARTERY DISEASE ASSESSMENT ANKLE/BRACHIAL INDEX (ABI) =.99 ABI test is a quick, noninvasive way to check your risk of peripheral artery disease (PAD). Peripheral artery disease is a condition in which the arteries in your legs or arms are narrowed or blocked. TOE/BRACHIAL INDEX (TBI) =.5 Determine the severity of peripheral arterial disease present in a lower extremity. F E E E D D C A A A A D Acceptable, Borderline F F D D C A A A A Normal range Ejection Elasticity Index (EEI):.6 EEI is an indicator for left ventricle ejection power and elasticity of large arteries. F E D C B A A B C D E F Borderline Normal Blood Circulation Dicrotic Dilation Index (DDI):.63 DDI indicates the contractility, tension and stiffness in the small arteries. F E D C B A A B C D E F Borderline Normal Blood Circulation Dicrotic Elasticity Index (DEI):.5 DEI represents the reflection of arterial elasticity and blood flow in the venous system. F E D C B A A B C D E F Normal Blood Circulation Coronary Respiratory Response: 2.6 E D C A A A CAD occurs when the blood vessels that transport blood to the heart are narrowed and hardened due to plaque buildup (atherosclerosis) Acceptable, Borderline Augmentation Index -.27 < -.7 Stroke Volume 64.6 ml 55- Blood Volume 5.25 l 3-5 DPTI/SPTI.28 ratio Blood Pressure 28/7 mmhg < 2 Reflection Index Cardiac Output 5.29 l/min C 2.72 ml/ >. mmhg Systemic Vascular Resistance Central Systolic Pressure 22 mmhg 2-24 Stiffness Index 8.55 m/s < 8. Mean Arterial Pressure 88 mmhg 7- C ml/ > 6. mmhg Pulse Oximetry 96.4 > 95 A - Normal B - Borderline Normal C - Moderate D - Borderline Abnormal E - Abnormal F - Severe 6 [s] PPG Printed: 9 May 28 2:8

5 ECG ANALYSIS REPORT Age:52 (DOB: Jan 966 2:) Exam Date: Sep 27 4:45 Recorded time Start Date :45:24 Duration 3 min (248 beats) High Pass Filters 3.4 Hz Heart Rate Average Heart Rate Fastest rate Slowest rate 82 bpm 89 bpm 77 bpm Ventricular Details PVC - Ventricular Ectopy beats (%) Ventricular Couplet episodes Supraventricular Details PAC - Supraventricular Ectopy beats (%) Supraventricular Couplet episodes Pause / Block Irregular / Artifact beat beats (.4%) HRV Analysis SDNN 23 ms QRS Analysis QRS QT / QTc PR int / seg ST int / seg 53 ms 32 ms / 355 ms 8 ms / 63 ms 246 ms / 5 ms PAC - Atrial Extrasystole: % PVC - Ventricular Extrasystole: % Irregular / Artifact beat:.4% Normal: 99.6% Interpretations: 7.6 [s] [mv] [s] [mv] Printed: 9 May 28 2:8

6 Arterial Vascular Assessment - Segmental Analysis Age:52 (DOB: Jan 966 2:) Exam Date: Sep 27 4:45 Resting - Right - Arm Standing - Arm Compare - Arm EEI =.64 DDI =.63 DEI =.5 AI = -.27 RI =.45 SI = 8.55 PTT = 55.4 ms DPTI/SPTI =.28 PWV = 5.8 m/s Systolic = 28 mmhg SpO2 = 96.4 % Diastolic = 7 mmhg CASP = 22 mmhg 4 [s] PVR EEI =.95 DDI =.87 DEI =.93 AI = -.7 RI =.32 SI = 7.79 PTT = 4.96 ms DPTI/SPTI =.8 PWV = 5.88 m/s Systolic = 28 mmhg SpO2 = 94 % Diastolic = 92 mmhg CASP = 22 mmhg 4 [s] PVR deei =.3 dddi =.24 ddei =.44 dai = -.43 dri = -.4 dsi = -.76 dptt = ms ddpti/dspti = -. dpwv =.7 m/s d Systolic = mmhg dspo2 = -2.4 % d Diastolic = 2 mmhg 4 [s] PPG 4 [s] PPG Resting - Right - Ankle Standing - Ankle Compare - Ankle EEI =.55 DDI =.63 DEI =.36 AI = -.4 RI =.4 SI = 6.87 PTT = ms DPTI/SPTI =.25 EEI =.7 DDI =.9 DEI =.7 AI = -.36 RI =.9 SI = 7.97 PTT = 2 ms DPTI/SPTI =. deei =.5 dddi =.28 ddei =.34 dai = -.2 dri = -.2 dsi =.9 PWV = 6.35 m/s SpO2 = 96.2 % Systolic = 6 mmhg Diastolic = 74 mmhg PWV = 3.62 m/s SpO2 = 9.8 % Systolic = 42 mmhg Diastolic = mmhg dptt = ms dpwv = m/s ddpti/dspti = -.4 d Systolic = -8 mmhg.8 [s].8 [s] dspo2 = -4.4 % d Diastolic = 36 mmhg Resting - Right - Compare Standing - Compare deei = -.9 dddi = ddei = -.4 deei = -.25 dddi =.3 ddei = -.23 dai =.3 dri = -.5 dsi = -.68 dai =.35 dri = -.2 dsi =.8 ftptt = 6.88 ms ddpti/dspti = -.3 ftptt = 7 ms ddpti/dspti = -.8 ftpwv = 9.73 m/s d Systolic = 3 mmhg ftpwv = 7.5 m/s d Systolic = 5 mmhg dspo2 = -.2 % d Diastolic = 3 mmhg dspo2 = -2.2 % d Diastolic = mmhg Ankle/Brachial Index (ABI) =.99 Toe/Brachial Index (TBI) =.5 Ankle/Brachial Index (ABI) =.3 Toe/Brachial Index (TBI) =.96 Acceptable, Borderline Printed: 9 May 28 2:8

7 SUDOMOTOR SYMPATHETIC RESPONSE HANDS Asymmetry = 22% (Unfavorable values: higher than 2 %) Bioelectrical Conductivity Response (dbec) = 7 (dbec correlate with Sweat Gland Function) 66 Bioelectrical Conductivity (BEC) = 88.8 µs (BEC correlate with Sweat Gland Nerve Density) Right µs FEET Asymmetry = 8% (Unfavorable values: higher than 2 %) Bioelectrical Conductivity Response (dbec) = 67 (dbec correlate with Sweat Gland Function) 66 Bioelectrical Conductivity (BEC) = µs Possible: Palmar Hyperhidrosis Right µs SUDOMOTOR AUTONOMIC NEUROPATHY Risk for sudomotor autonomic neuropathy = 3.9 (No risk if < 4, Moderate 4-6, Elevated risk if > 6) Sudomotor autonomic neuropathy correlate with Sweat Gland Nerve Density and Sweat Gland Function Right: Foot Left: Foot Printed: 9 May 28 2:8

8 BIOELECTRICAL IMPEDANCE ANALYSIS (BIA) BIOELECTRICAL IMPEDANCE ANALYSIS Parameter Value Norms Weight 83 kg high cell% low water% Fat-Free Mass 79 % 78-9 Body Fat Mass 2 % -22 Intracellular Water 34 % 34-4 Extracellular Water 25 % Total Body Water 59 % OBESITY ANALYSIS high water % R low cell% Parameter Value Norms Body Mass Index 27 kg/m law muscle mass obesity Body Fat-Free Mass Index 2 kg/m Body Fat Mass Index 6 kg/m Hydration Phase Angle (5KHz) 7.79 >6. Basal Metabolic Rate BODY COMPOSITION 75 kcal chronic energy d fi i FFMI high muscle Values Total Body Water Fat-Free Mass Weight Intracellular Water 28kg (34%) 49kg (59%) Extracellular Water 2kg (25%) 66kg (79%) Dry Lean Mass 7kg (2%) 83kg Body Fat Mass 7kg (2%) Body Mass Index (BMI) = 27 D C B A A B C C D D E E F F Basal Metabolic Rate (BMR) = 75 cal Total Daily Energy Expenditure = 2626 cal Risk of Associated Disease According to BMI and Waist Size 8.5 or less: Underweight : Normal - very low risk of associated diseases 23-25: Borderline Normal - Increased Risk 25-3: Overweight - prone to health risks 3-35: Overweight to Obese - high risk of associated diseases 35-4: Obese - very high risk of associated diseases 4 or greater: Extremely Obese - very high risk of associated diseases Printed: 9 May 28 2:8

9 Electro Interstitial Scan - Living Tissue DIGESTIVE SYSTEM Interstitial ph = 64 (>5)(7.9) Na+/K+APTase Activity = 54 (>5)(42.3) Oxygen Delivery = 5 (>5)(.4) Intracellular Water = 33.2% (34-4) Hydration = 74.3% (55-7) Dry Lean Mass = 2.3% (5-3) Overall Score = 54 CARDIOVASCULAR SYSTEM Interstitial ph = 7 (>5)(7.7) Na+/K+APTase Activity = 72 (>5)(4.4) Oxygen Delivery = 52 (>5)(.5) Intracellular Water = 4.6% (34-4) Hydration = 72.3% (55-7) Dry Lean Mass = 9.5% (5-3) Overall Score = 64 HORMONAL/THYROID SYSTEM Interstitial ph = 7 (>5)(8.2) Na+/K+APTase Activity = 54 (>5)(4.5) Oxygen Delivery = 52 (>5)(.5) Intracellular Water = 33.4% (34-4) Hydration = 73% (55-7) Dry Lean Mass = 2.3% (5-3) Overall Score = 56 UROGENITAL & RENAL SYSTEM Interstitial ph = 6 (>5)(7) Na+/K+APTase Activity = 6 (>5)(5.2) Oxygen Delivery = 5 (>5)(.4) Intracellular Water = 36.% (34-4) Hydration = 75.% (55-7) Dry Lean Mass = 9.8% (5-3) Overall Score = 55 RESPIRATORY SYSTEM Interstitial ph = 74 (>5)(7.4) Na+/K+APTase Activity = 86 (>5)(4.2) Oxygen Delivery = 53 (>5)(.5) Intracellular Water = 37.9% (34-4) Hydration = 84.8% (55-7) Dry Lean Mass = 25% (5-3) Overall Score = 7 BRAIN SYSTEM Interstitial ph = (>5)(25.2) Na+/K+APTase Activity = 58 (>5)(44) Oxygen Delivery = 56 (>5)(.6) Intracellular Water = 26% (34-4) Hydration = 69.% (55-7) Dry Lean Mass = 25% (5-3) Overall Score = 57 Printed: 9 May 28 2:8