The following heart and circulation markers will be evaluated during this process. Many of these markers are similar to an ECG (electrocardiogram) used by cardiologists:

• Pulse Rate: Resting heart rate in beats / minutes.
• Pulse Recognition: Shows what percentage of pulses were recognized. Low recognition could point to serious heart issues. Similar to electrocardiogram.  
• Ejection Time (ETc): The time it takes for the left ventricle to contract. Similar to echocardiogram.
• Pulse Height / Pulse Amplitude (PH): The amount of pressure / volume with each heart beat. Similar to stroke volume.
• Plethysmograph Waveform (PTG): The shape of this waveform is a good indication of arterial elasticity.
•  Dicrotic Wave Detection: Existence of Dicrotic notch on plethysmograph waveform is a good indication of arterial elasticity.
• Accelerated Plethysmograph (APG): A good way of measuring the biological age of arteries.
• Ejection Elastic Index (EEI): An indicator for left ventricle ejection and elasticity of large arteries
• Dicrotic Dilation Index (DDI): An indicator for small artery compliance
• Dicrotic Elastic Index (DEI): Peripheral vessel elasticity (arterioles to veins)

  Heart Rate Variability (HRV) Evaluation:

This is the second part of this Comprehensive Cardiovascular evaluation. HRV reflects heart's ability to adapt to changing circumstances by detecting and quickly responding to unpredictable events.

Low HRV has been shown in numerous studies to be related to a higher mortality rate in both healthy and unhealthy subjects.

There are two methods for evaluating HRV, (Time Domain and Frequency Domain) and both of them are used here.The following markers will be evaluated and calculated for Heart Rate Variability measurement:

Time Domain Method:

• SDNN: Standard Deviation, Normal to Normal heart beat. Good estimate of ANS status
• RM-SSD: Good estimate of parasympathetic regulation of heart (PNS)
• Mean HRT: Average heart rate over 5 minutes
• Mean NN: Average time between two regular heart beats (normal to normal)

Frequency Domain Analysis (Spectral Analysis):

• Total Power (TP): Overall "vitality" in the nervous system across all frequencies
• Very Low Frequency (VLF)
• Low Frequency (LF): Reflects both sympathetic and parasympathetic activities
• High Frequency (HF): Reflects parasympathetic (valal) tone and fluctuations caused by respiration known as respiratory sinus arrhythmia.
• LF / HF Ratio: Indicates overall balance between sympathetic and parasympathetic system.
• Sympathetic Nervous System Balance (SNS:PNS)
• Autonomic Balance Diagram (ABD): Most important part of HRV evaluation. Indicating active status of autonomic nervous system.

Complete Blood Count (CBC):

• WBC - White blood cells are the body's primary defense against disease. White blood cells help fight infection.
• RBC - Red blood cells are responsible for carrying oxygen and carbon dioxide to all cells. Iron deficiency will lower RBC.
• Hemoglobin - A chemical compound inside red cells that transports oxygen through the blood stream to all cells of the body. Oxygen is needed for healthy organs. Hemoglobin gives the red color to blood.
• Hematocrit - Hematocrit measures the amount of space red blood cells take up in the blood. It is reported as a percentage.
• Lymphocytes - The results of this and basophils, eosinophils, monocytes and neutrophils deal with white blood cell function. Important to the body's defense against infection. Also important in the assessment of nutritional status.
• Monocytes - The results of this and basophils, eosinophils, lymphocytes, and neutrophils deal with white blood cell function. Important to the body's defense against infection. Also important in the assessment of nutritional status.
• MCH Mean- corpuscular hemoglobin is one way to measure the average hemoglobin concentration within red blood cells, which varies from normal with different diseases.
• MCHC Mean- corpuscular hemoglobin concentration.
• MCV Mean- corpuscular volume measures red blood cell volume. Monocytes Important in the assessment of nutritional status.
• Neutrophils - The results of this and basophils, eosinophils, lymphocytes, and monocytes deal with white blood cell function. Important to the body's defense against infection. Also important in the assessment of nutritional status.
• Platelets - Blood cell particles involved with the forming of blood clots.
• RDW - Red cell distribution width (RDW) is a calculation of the variation in the size of your RBCs. In some anemias, such as pernicious anemia, the amount of variation (anisocytosis) in RBC size (along with variation in shape – poikilocytosis) causes an increase in the RDW.esterol, heart disease, blood tests, cholesterol, heart disease

Thyroid Profile:

• Total T-4 (Thyroxine): Inactive Thyroid hormone produced in thyroid gland
• T-3 uptake: Inactive thyroid hormone produced in the thyroid gland and converted to actuve T-3 in lung, liver, and intestines.
• Free-Thyroxine Index (FTI) T-7
• TSH: Thyroid stimulating Hormone produced by hypothalamus to control thyroid hormone production.

Lipid Profile:

• Cholesterol, Total - A sterol in the blood. Knowing your cholesterol may be as important as knowing your blood pressure. Elevated cholesterol is associated with an increasing risk of coronary heart disease.
• HDL - Cholesterol High-density lipoproteins are believed to take cholesterol away from cells and transport it back to the liver for processing or removal. They have become known as the "good" cholesterol as persons with high levels of HDL may have less heart disease. Low HDL could be the result of smoking and lack of exercise. LDL - Cholesterol Low-density lipoproteins contain the greatest percentage of cholesterol and may be responsible for depositing cholesterol on the artery walls. For that reason, they could be known as the "bad" cholesterol.
• Cholesterol/HDL Ratio - Calculated by dividing the total cholesterol by the HDL cholesterol. Ratio used by physicians in determining your relative risk for developing cardiovascular heart disease.

• Triglycerides - Triglycerides is a fat in the blood responsible for providing energy to the cells of the body. Triglycerides should be less than 400 mg/dl even in a non-fasting state.

Liver Profile:

• Alanine aminotransferase (ALT or SGPT) - an enzyme found primarily in the liver. Abnormalities may represent liver disease.
• Albumin - serum one of the major proteins in the blood and a reflection of the general state of nutrition.
• Albumin/Globulin ratio - Calculated by dividing the albumin by the globulin.
• Alkaline phosphatase - A body protein important in diagnosing proper bone and liver functions.
• Aspartate aminotransferase (AST or SGOT) - an enzyme found in skeletal and heart muscle, liver and other organs. Abnormalities may represent liver disease.
• Bilirubin, Total - A chemical involved with liver functions. High concentrations may result in jaundice.
• Globulin, Total - A major group of proteins in the blood comprising the infection fighting antibodies.
• Lactate Dehydrogenase (LDH) - An enzyme found mostly in the heart, muscles, liver, kidney, brain, and red blood cells. When an organ of the body is damaged, LDH is released in greater quantity into the blood stream.
• Protein, Total - Together with albumin, it is a measure of the state of nutrition in the body.
• GGT - GGT Also known as: Gamma-glutamyl transpeptidase, GGTP Formal name: Gamma-glutamyl transferase helps to detect liver and bile duct injury. Some doctors use it in all people they suspect of having liver disease, others use it only to help explain the cause of other changes or if they suspect alcohol abuse

Kidney Profile:

• Urea Nitrogen (BUN) - A by-product of protein metabolism eliminated through the kidneys. BUN is an indicator of kidney function.
• Creatinine, Serum - An indicator of kidney function.
• Uric acid - Another by-product of protein metabolism eliminated through the kidneys. Uric acid is an indicator of kidney function.
• Bun/Creatinine - Ratio Calculated by dividing the BUN by the Creatinine.

Bone & Minerals:

• Iron, Total - An abnormally low test result may indicate iron deficiency anemia.
• Calcium - A mineral essential for development and maintenance of healthy bones and teeth. It is important also for the normal function of muscles, nerves and blood clotting.
• Phosphorus - Together with calcium, it is essential for healthy development of bones and teeth. Associated with hormone imbalance, bone disease and kidney disease. It is found mainly in bones and teeth. NOTE: a temporary drop in phosphorus level can be seen after a meal.

Fluids & Electrolytes:

• Chloride, Serum - Similar to sodium, it helps to maintain the body's electrolyte balance.
• Potassium - Helps to control the nerves and muscles.
• Sodium, Serum - One of the major salts in the body fluid; sodium is important in the body's water balance and the electrical activity of nerves and muscles.
• Carbon Dioxide - ordered as part of an electrolyte panel. The electrolyte panel is used to detect, evaluate, and monitor electrolyte imbalances.