THE SCIENCE OF HEMOTAG

CARDIAC TIME INTERVALS AS EARLY PROGNOSTIC OF HEART DISEASE

Heart Failure
Cardiac Time Intervals (CTIs) are defined by the opening and closing of the valves of the heart with respect to the start of the QRS complex, which in turn is determined by pressure and volume differences across the valves. In the ailing heart, CTIs change corresponding to the disease progression. As the left ventricular (LV) systolic function deteriorates, it takes longer for the cardiomyocytes to achieve an LV pressure equal to that of aorta, resulting in a delayed aortic valve opening. Furthermore, the ability of cardiomyocytes to maintain the LV pressure decreases, resulting in an early aortic closing. As LV diastolic function declines, diastolic relaxation proceeds more slowly, resulting in delayed mitral valve opening. Similarly, increase in the pulmonary artery pressure, results in delayed mitral valve closing. Currently CTIs can be obtained by the conventional echocardiogram. In large prospective studies, CTIs have been shown to be predictive of hemodynamics. This is because CTIs are indicative of myocardial structure and function, namely, pulmonary artery pressures and both left ventricular systolic function and left ventricular diastolic function.
Cardiac time intervals can identify left ventricular systolic dysfunction (LVSD) in patients.
Cardiac time intervals can identify left ventricular systolic dysfunction (LVSD) in patients. Pre-ejection period (PEP = Q to Aortic valve open) is longer, whereas left ventricular ejection time (LVET= Aortic valve open to Aortic valve close) is shorter in heart failure patients. Thus, PEP/LVET is significantly increased in heart failure patients. Shown are comparative analyses of a healthy patient (left column) and a patient with significant heart failure (right column).

HEMOTAG acoustic heart function analysis- (E, F) No ECG rhythm abnormalities detected in either subject, (G) identified normal function with PEP/LVET=0.26 and (H) Significant LVSD with PEP/LVET =0.63.

HEMOTAG was compared to gold standard Transthoracic echocardiogram. Biplane Simpson’s ejection fraction (EF)- (A) normal function with EF=67% and (B) significant LVSD with EF=33%. Pulsed Doppler aortic acquisitions using apical 5 view demonstrate accurate assessment of PEP at beginning of aortic ejection and LVET at termination of aortic flow. Total duration for the echo assessment with a certified sonographer: 45 minutes. Total duration for the HEMOTAG assessment with minimally trained staff: 5 Minutes.

HEMOTAG CPAS is designed to screen for the following:

  • Systolic dysfunction
  • Diastolic dysfunction
  • Elevated pulmonary artery pressure
  • Atrial fibrillation detection

Clinical Application Notes

 
HEMOTAG CPAS Fact Sheet

HEMOTAG CPAS.  The Importance of Early Diagnosis

HEMOTAG CPAS.  Diabetes Clinical Application

HEMOTAG CPAS in Urgent Care

 

REFERENCES AND PUBLICATIONS

PUBLICATIONS

  • D. Urina (2020), Non-invasive Assessment of Left Ventricular Pressure Using Cardiac Time Intervals from HEMOTAG. Journal of the American College of Cardiology, Chicago, March 2020.
  • S. Sehatbakhsh, et.al, (2018), Assessment of LV systolic function using cardiac time intervals with an acoustic array approach, Journal of Cardiac Failure, Volume 24, Issue 8, Supplement, August, Pages S38.
  • S. Hakimian, et.al, (2018), NYHA functional class and ASE diagnosis effects on echo variables and cardiac time intervals with an acoustic array approach, Journal of Cardiac Failure, Volume 24, Issue 8, Supplement, August, Pages S39-S40.
  • K. Kale, et.al, (2018), Assessment of Reduced Left Ventricular Ejection Fraction Using Isovolumic Contraction dP/dt From HEMOTAG, American Heart Association Scientific Sessions, November, Vol 138, Issue Suppl_1.
  • M. Skowronski, et.al., (2018), Cloud connected non-invasive medical device for instant left ventricular dysfunction assessment via any smartphone, iproc 2018;4(2):e11880.
  • S. Borzak, et.al, (2018), Acute Cardiac Care-Israel: Cloud-connected non-invasive device for the early detection, diagnosis, and quantification of Heart Failure in patients with diabetes mellitus, 11th International Conference Acute Cardiac Care, June, Israel.
  • S. Hakimian, et.al, (2017), Systolic Time Ratios via HEMOTAG and 2D Echocardiography: Correlations with Ejection Fraction and Implications for Clinical Practice, J. of Cardiac Failure, Vol. 23, Issue 8, Supplement, August, Pages S48-S49.
  • M. Kabach, et.al., (2017), Pre-Ejection Period and Systolic Time Ratio by HemoTag Correlates with Mean Pulmonary Capillary Wedge Pressure by Right Heart Catheterization: Implication for Diagnosis and Clinical Practice, Journal of Cardiac Failure, Volume 23, Issue 8, Supplement, Page S103.
  • A. Alrifai, et.al, (2017), Electromechanical Activation Time via HEMOTAG Correlation with Pulmonary Artery Pressure by Right Heart Catheterization: Implications for Diagnosis and Clinical Practice, Journal of Cardiac Failure, volume 23, Issue 8, Supplement, Page S50.
  • S. Hakimian, et.al, (2017), Electromechanical Activation Time via HemoTag and 2D Echocardiography: Correlation with Tricuspid Regurgitation Peak Velocity and Implications for Diagnosis and Clinical Practice, Journal of the American College of Cardiology, Volume 69, Issue 11 Supplement, March.
  • K. Kale, et.al, (2017), Cloud connected non-invasive device correlation with Pulmonary Artery Pressure by Right Heart Catheterization: Implications for diagnosis and clinical practice to improve outcomes for HF patients, iproc;3(1):e34
  • K. Kale, et.al, (2018), Poster abstract, HEMOTAG: A non-invasive, easy-to-use, portable medical device for absolute, accurate and actionable monitoring fluid shifts in trauma patients, Defense TechConnect Conference & Expo, October.
  • K. Kale, et.al, (2017), Poster abstract, HEMOTAG: A cutting edge non-invasive, easy-to-use and mobile medical device for rapid automated measurement of subclinical changes in cardiac structure and function, Military Health System Research Symposium, August.
  • K. Kale, et.al, (2017), Poster abstract, HEM0TAG: A cutting edge non-invasive, easy-to-use and portable medical device for the detection and monitoring of hemorrhage, Military Health System Research Symposium, August.

ISSUED PATENTS

  • System and method of extraction of the heart valve signals. (Patent No: US 10,165,985 B2. January 1, 2019)
  • Method and system of an acoustic scene analyzer for body sounds (Patent No: US 8,475,396 B2. July 2, 2013)
  • System and method of extraction of the heart valve signals. (US Patent 10,165,985)
  • System and method of extraction, identification, marking and display. (US Patent ApplicationUS 2017/0188862 A1)