Dr. John M Freedman after a huge JAMA study showed that people who sit for long periods at work have far greater cardiovascular and mortality risks.

Remote Care

CardioSignal Looks to Expand CVD Detection through Patients Phones

Expanding access to heart disease detection is one of cardiology’s biggest challenges, and Finnish startup CardioSignal just raised $10M to address that challenge using one of the most accessible devices in the world – the smartphone.

• CardioSignal uses a proprietary algorithm that analyzes heart motion data produced by smartphones when placed on patients’ chests.
• The Series A round increases CardioSignal’s total funding to $23M, which it will use to support its ongoing clinical validation and expand its commercial efforts. 

CardioSignal leverages smartphone gyroscope and accelerometer motion sensors to non-invasively measure heart motion and determine cardiac health and function. 

• These exams require users to place their phone on their chest for one minute, creating measurements that are analyzed by CardioSignal’s cloud-based gyrocardiography algorithm, which then sends results to users and/or their clinicians.
• CardioSignal has already developed digital biomarkers for AFib and heart failure, while more solutions could be on the way for aortic stenosis, coronary artery disease, and pulmonary artery hypertension.

This approach might seem far out to many readers, but CardioSignal’s AFib and heart failure biomarkers have been validated in clinical studies, including one that showed relatively high sensitivity and specificity for AFib detection (95.3% & 96.0%).

• The CardioSignal AFib application has also already earned European CE Marking as a Class IIa medical device, allowing its use in 15 countries.

Noting that underdiagnosis and diagnostic inaccessibility are part of the reason that cardiovascular disease is the world’s number one killer, CardioSignal positions itself as an early detection solution for primary care physicians – before their patients even have their own cardiologist and before they have later-stage disease.

• That’s a big difference versus most remote cardiac diagnostic or monitoring programs, which are generally reserved for patients who are already symptomatic, and rely on dedicated medical devices like ECG monitors.

The Takeaway

Considering that there are 209k PCPs in the US alone (plus another 86k primary care NPs and PAs), becoming primary care’s go-to solution for early CVD detection is a massive goal. CardioSignal will face plenty of challenges in achieving that goal, but the fact that many of its targeted patients already own a smartphone also gives it an intriguing head start.

Precision QRS Detection

QRS detection is essential for any ECG algorithm, and Monebo’s Kinetic QRS ECG Algorithm sets the standard for accuracy. Kinetic QRS accurately detects the QRS complex, no matter the amplitude, waveform, or noise levels.

HeartFlow FFRCT Catches Missed Blockages

Karen Moore had always been diligent about her heart health, which is why she was concerned when she began showing symptoms of heart disease but all of her tests came back negative. See how Karen and her physician used HeartFlow FFRCT to catch a 90% blockage and place a stent in the right location, before it was too late.

Merge and Duly Health Streamline Cardiology Reporting

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The Wire

• Nexletol Up Next for CVD Treatment: In a potential breakthrough for preventive heart health, individuals with high cardiovascular risk and statin intolerance saw a 20% relative risk reduction in MACE-4 when administered bempedoic acid (Esperion’s Nexletol) compared to a placebo. The authors suggest that bempedoic acid’s potential treatment benefits may translate into 25 fewer MIs, 32 fewer coronary revascularizations, and 7 fewer strokes over a 5-year period for each 1,000 patients treated.

• “Striking” Impact of Hospital Diagnostic Errors: A study in JAMA Internal Medicine found that nearly a quarter of hospitalized patients who died or were transferred to the ICU experienced a diagnostic error. After examining data from 2,428 patients across 29 academic medical centers, researchers identified 550 who had a diagnostic error (23%), with 436 experiencing harm as a result (18%). The underlying problems with the greatest association to diagnostic errors (and probably good starting points for safety improvement efforts), were errors in testing and clinical assessment.

• Acorai’s Seed Funding: Swedish heart failure start-up Acorai scored $4.5M in Seed funding, which it will combine with $13.3M in government grants and funding to support its clinical studies and advance its path towards regulatory approval. Acorai’s Heart Monitor, which gained FDA Breakthrough Device designation last year, is a non-invasive intracardiac pressure monitoring device that combines hardware and machine learning to identify hemodynamic congestion and support personalized heart failure treatment.

• Which Imaging is Best for Guiding PCI? The head-to-head OCTIVUS study evaluated optical coherence tomography (OCT) against intravascular ultrasound (IVUS) for guiding PCI, finding statistically similar CV event rates among 2,008 patients with complex coronary lesions. OCT and IVUS-guided PCIs had similar primary composite event rates at two years (6.5%  vs.  7.4% for CV death, target vessel-related MI, or ischemia-driven target vessel revascularization), while OCT had significantly lower major complication rates (1.7% vs. 3.4%).

• FFRCT’s CPT I Code: AI-based FFR-CT exams improved upon their already-strong reimbursement value proposition, after HeartFlow announced that FFRCT analysis transitioned to a Category I CPT code on January 1 (75580), replacing four existing Category III CPT codes (0501T-0504T). The new Category I CPT code now allows RVU-based payments to physicians for using the AI-based service in hospital outpatient, physician offices, or imaging centers, and increases hospital-based payments by roughly 7%.

• Too Much Sitting Hurts Heart Health: A massive occupational study of about 482k people in Taiwan found that people who mostly sit at work have a 34% higher risk for cardiovascular disease and a 16% higher all-cause mortality risk than those who mostly don’t sit while working. That’s after adjusting for many factors including age and BMI. The good news is, ‘mostly sitters’ could counteract these hazards by adding 15 to 30 minutes of physical activity daily and alternating between sitting and “non-sitting.”

• NAD Speeds Tachycardia Healing: Stanford researchers found that NAD (a molecule that supports energy reactions) could aid in tachycardia recovery. The researchers induced tachycardia in stem cell-derived models of human heart tissue, finding that samples supplemented with NAD recovered 83% of their original function after the first day. While untreated samples still demonstrated a full recovery after the induced tachycardia was stopped, those supplemented with NAD exhibited accelerated recovery, showcasing the potential of NAD supplements to restore chemical balance.

• CAC Scans Scare Patients Straight: People shown their own CT coronary artery calcium scores might be more likely to make lifestyle changes that reduce their cardiovascular risks. In the CAUGHT-CAD study of 449 people aged 40-70 who had no symptoms but had some risk factors, those who were shown their CAC scores annually and got statin therapy had a greater reduction in Framingham risk scores (-3.4%) after three years, as well as greater reductions in systolic blood pressure and waist circumference.

• Expanding Echo Access with AI: A new study out of South Africa highlighted how AI-enhanced handheld ultrasound can enable minimally trained clinicians to evaluate and monitor left ventricular hypertrophy, thus expanding echo access in low-resource settings. The researchers had sixteen nurses and nurse-assistants without prior echo experience undergo a two-day handheld ultrasound training on assessing parasternal long axis views. The clinicians obtained 756 echocardiograms, finding that 83.3% were evaluable using Us2.ai’s echo AI algorithm, and 81.9% of those exams were confirmed by a cardiologist without changes.

• Hospitals Continue to Stabilize: KaufmanHall’s Hospital Flash Report for December showed that hospital operating margins now stand at 2%, another sign of a stabilizing pandemic recovery as key metrics like inpatient and outpatient revenue increased year-over-year. Revenue per discharge continued to increase while expense per discharge decreased, reflecting shifts toward more effective care settings and a reduced reliance on contract labor. On the flip side, the gap between high and low performers remains “quite wide,” and the numbers don’t yet reflect the seasonal surge in respiratory illness.

• Bio-Marking Differences in Patients with HF: A recent study published in Circulation: Heart Failure provided insights into the metabolic profiles of patients with heart failure. The biomarkers 3-IPA and 1-MetHis both had an AUC ≥0.8 for identifying HF, while SDMA and KYN were identified as suitable biomarker candidates for acute decompensated heart failure and chronic heart failure (both AUC ≥0.85). The authors concluded that these unique metabolic signatures could be valuable for diagnostic and prognostic heart failure tools.

Experience the Future of Learning: Medtronic Academy 2.0 is Here!

Unlock your ultimate destination for structural heart medical education with the newly redesigned Medtronic Academy 2.0. Gain access to expert-led courses, webinars, and a wealth of resources to stay ahead in cardiovascular care. Visit now!

Incidental CAC Predicts Long-Term Risks

What if you could identify which of your asymptomatic patients have high risks of future cardiac events? Stanford-led researchers used Bunkerhill Health’s Incidental CAC algorithm to do just that, finding that patients with ≥100 incidental CAC scores had a 24% 10-year risk of developing ASCVD and far higher risks of major adverse events.

The Resource Wire

• Optimizing Your Post-Processing Workflow: The growth of cardiac CT and CMRI volumes and continued shortages in the imaging technologist workforce can mean big challenges for imaging organizations. Join this Cardiac Wire Show starring Precision Image Analysis’ Jim Canfield and Cleveland Clinic’s Scott D. Flamm, MD, MBA to see how outsourcing cardiac image post-processing can solve this problem, while improving efficiency, accuracy, and standardization.

• Explore the Potential of Cardio AI: Explore the potential of AI-powered cardiology solutions in this on-demand TeraRecon webinar, detailing how its Cardio Suite solutions help expedite disease diagnosis, care coordination, and provide the data to support cardiac treatment decisions.

• Leveraging a Proven Echo AI Platform: Us2.ai has developed a promising new pathway for bringing custom echo AI applications into widespread clinical and commercial use – historically a challenge for algorithms produced by health systems and academic institutions. Find out how it worked in a Ugandan RHD program here.

• The Behavioral Science Behind Change Cardiology Hemo: When Change Healthcare set out to design its next-generation Cardiology Hemo monitoring system, they put behavior science at the heart of its product strategy. See how Change’s UX designers applied its behavioral science team’s findings to improve its Hemodynamics solution to help make physicians and technicians even more efficient.

• Staging Coronary Artery Disease: Believe it or not, there’s been no clinically relevant atherosclerosis staging system used to characterize heart disease — until now. Check out Cleerly’s four-stage system for evaluating atherosclerotic plaque burden, which is the direct cause of coronary artery disease (CAD).