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HFSA 22: Heart Failure Recognition with Micro Electro-mechanical Sensors

Published: 15 Nov 2022

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HFSA 22 - In this interview, Dr Juuso Blomster (Precordior Ltd, Turku, FI) joins us to share the results of the REFLECS Trial (NCT04378179), originally presented at HFSA 2022. 

This trial aimed to evaluate the Precordior CardioSignal app's efficacy in measuring patients cardiac motion and function in comparison to echocardiography. Over 200 patients were recruited to this observational study.

Questions: 

What is the background of this study?
What is the study design and patient population?
What are the key findings?
What are your take-home messages?
What further research is required? 

Recorded remotely from Turku, 2022.

Interviewer: Jordan Rance
Videographer: Oliver Miles

Transcript

" - So my name is Dr. Juuso Blomster. I'm a cardiologist and I work as an associate professor of cardiology in the University of Turku, in Turku, Finland. And I also hold a position as a chief physician in the Southwestern Finland Hospital District where I work as a chief physician in the research services.

Background of the Study

The background of the study is really coming actually already from 10 years ago when we started investigating different types of sensors. In this process we actually quite soon realised that if we combine two common motion sensors, accelerometer and gyroscope, which are actually found in common smartphones. And when those sensors are placed on your chest we can actually read your heart motion through your chest. And, this was then you know, originally we started investigating this and validated against different types of echocardiographic methods, how to assess your heart, tissue dopplers, strain imaging, even speckle tracking were used in these processes. And, there is actually the background. When we were investigating this, we actually realised that with this kind of technology it is plausible that, you know, we could detect those changes and signs of heart failure that you know, develop during the disease. You know, increased filling pressures, disturbances in left ventricular function. So, these were the details that we wanted to investigate and initiated this bigger study which was conducted in Europe and in United States to address heart failure with mechanoelectrical sensors.

Study Design and Patient Population

The study design is really to understand these sensors and how they are recording your heart in different stages of heart failure. And this was actually addressed so that we enrolled patients who had acute heart failure. Acute decompensated heart failure when they are admitted to hospital and are really in their acute stages. So the idea was to enrol these kind of patients within 24 hours when they're coming to hospital. Then also follow them up until they are discharged from the hospital so that we actually see the acute phase when it's stabilised. And then thirdly, we wanted to also address individuals who have stable compensated heart failure. So we for this purpose, we enrolled individuals who came for hospital visit or outpatient visit, or for their heart failure and, but also those individuals who had been hospitalised for their acute heart failure three months earlier. So we actually invited these individuals who we had already enrolled earlier for an outpatient visit where we examined them in their stable, compensated heart failure stage. So, these three stages were those where we were addressing heart failure and we were actually addressing heart failure in both individuals with preserved ejection fraction and in individuals with reduced ejection fraction. So, trying to understand the mechanistic features that we are able to identify these motion sensors in these two different types of heart failure and also in the different stages of heart failure from acute to the compensated heart failure.

Key Findings

Well the key findings is that actually these features and these signals that we are able to collect with the motion sensors. And when we are comparing these to the hemodynamics, the filling pressures, those other specific details that you can see in heart failure. And even with echocardiography verified findings these are actually something that reflect in the features. And with this, we are able to understand that there are specific features that are related to heart failure and this is something that can be identified with this technology. So, even though we realise that, you know, this is the first bigger study where we've been addressing this, the findings and the results are actually very promising.

Take-Home Messages

Digitalization in cardiac care is something that is coming. And you know when thinking about the healthcare disparity, especially thinking about you know, these different types of minorities, rural areas for example where the access to care is limited. So, when thinking about these and thinking about how broadly for example, smartphones are available, the idea that smartphones could be utilised for screening tool or for a follow up tool, for example in heart failure when assessing cardiac condition, I think it, it has a huge promise. It has a really significant impact. And our mission here is really to you know, take this forward and really bring a tool for colleague physicians to be using and addressing heart failure patients so that you know. the care could be improved even further what it is today.

Further Research Required

For further research I would say that we would need a more, more studies on the topic. So, what we have at the moment is that clear that you know we have, we understand that what features and what is the condition that happens there when using these motion sensors and addressing your heart in different stages of heart failure. But as you know how cardiology and you know our medical scientific world works, we need more evidence on the topic. So we have now one study showing that you know, there are, there's you know, results are good and there's great promise. But then overall what I would say that we need in the future really is more studies on the topic so that we are able to provide that robust level of evidence addressing cardiac patients, heart failure patients in different conditions so that we are able to show that this technology can be helpful in identifying heart failure patients. Early detection is definitely one of the areas where I can see in the future where this kind of technology has the promise. But also, thinking about heart failure patient follow up. As we know that you know, individuals with heart failure, they have, you know, increased risk of developing a new decompensated heart failure. So, understanding these, these individuals and how we would be able to address them with this technology. I think those are the key areas, two key areas where I would like to see more clinical studies happening in this area and actually our team back here in Finland is happy to collaborate and you know, participate in studies around these topics. But I think these are the ones that we need when we are really aiming to have a significant impact for patients and for healthcare. So, this is where digitalization in cardiology especially is going and I'm really excited about the future in that sense.