Abstract 4146441: Non-invasive Algorithmic Hemodynamic Measurements Using Wearable Cloth-based Nanotechnology: Alternative to Invasive Right Heart Catheterization
Ameesh IsathShazli KhanArjun KanwalVasiliki GregoryPrashanth S. KumarMouli RamasamyVenk VaradanJohn ZimmermanVijay K. VaradanAlan Gass
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Background: SimpleSense (Nanowear, New York, NY) is an FDA-cleared artificial intelligence (AI) based wearable diagnostic platform with multiparametric monitoring including 2-leads of ECG, thoracic impedance, heart sounds, blood pressure, posture and activity (Fig. 1 A). We explored the correlation between SimpleSense-derived and invasive hemodynamics (HD) parameters during right heart catheterization (RHC). The SimpleSense parameters assessed included amplitudes and width of heart sounds S1 and S2, ECG amplitudes, R to S1 and S2 times (Fig. 1 B), and pulse ejection period (PEP). PEP is a surrogate measurement that combines the pre-ejection period and left ventricular ejection time (Fig. 1 C). Methods: A single-center prospective feasibility study was conducted after IRB approval. Adult patients >18 yrs undergoing RHC were screened and enrolled after informed consent (NCT05629533). SimpleSense recorded data on the patients throughout the RHC procedure. We performed an exploratory analysis to identify potential correlations between the SimpleSense data and HD parameters utilizing maching learning. Results: Data from 11 subjects (8 Males, age:64.3 ± 10.23 yrs.) included 39 thermodilution cardiac outputs (CO) and 11 pulmonary artery pressures (PAP). The mean ± SD values of CO, cardiac index (CI), Systolic PAP, Diastolic PAP, and mean PAP were 4.4±1.9 l/min, 2.19±0.96 L/min/m 2 , 37.27±17.32 mmHg, 12.09±5.03 mmHg, and 22.72±8.42 mmHg respectively. Multiple SimpleSense derived data show statistically significant correlations with HD parameters (Fig. 2). The PEP metric exhibited the highest correlation with mean PAP and systolic PAP. Conclusion: The results highlight SimpleSense’s potential as a non-invasive AI tool that could revolutionize management by offering a reliable alternative to traditional invasive RHC. With further validation, SimpleSense may provide continuous, real-time hemodynamic information, significantly enhancing patient care and outcomes.Keywords:
Cardiac catheterization
Right heart catheterization
Right heart catheterization
Cardiac catheterization
Pulmonary angiography
Angioscopy
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Right heart catheterization
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Cardiac catheterization
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Pulmonary angiography
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To the Editor:—
The authors share Dr. Smith's understandable curiosity concerning the nature of the patient's cardiac anomaly and would be most interested in the results of a second catheterization of the right side of the heart. However, we were mightily impressed with our patient's cardiorespiratory reserve, which far exceeded our own individually or as a relay team. There was no medical justification for repeating the studies, and try as we might, nowhere could we find that the number of research grants supporting a clinical investigation constituted an indication for cardiac catheterization.Right heart catheterization
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The diagnosis of pulmonary arterial hypertension (PAH) depends on hemodynamic parameters assessed during right heart catheterization (RHC). Besides being essential for diagnosis important information on severity of the hemodynamic impairment, too, can be assessed. Currently, two methods are recommended: the direct Fick and the thermodilution method. Hoeper et al. reported that both methods are equal value in PAH patients. However, nothing is known on the influence of the patient position on hemodynamic parameters.
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CATHETERIZATION of the left side of the heart1 2 3 4 has made possible a variety of physiologic investigations5 6 7 8 of the heart and circulation. In addition, measurements of pressures in the left side of the heart have been found invaluable in the precise characterization of lesions of the mitral and of the aortic valve. Such studies have also facilitated the clinical assessment of adult patients with acquired heart disease in whom the results of the usual clinical examinations and right-sided catheterization leave the diagnosis in doubt. In the present report the usefulness of catheterization of the left side of the heart is demonstrated . . .
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