Wireless device detects heart dysfunction in child cancer survivors
A prototype wireless device designed for detection of heart dysfunction in childhood cancer survivors treated with chemotherapy is comparable to cardiac magnetic resonance imaging.
That’s the conclusion of researchers who compared the accuracy of the Vivio handheld mHealth platform with both echocardiography and CMR imaging for assessment of cardiac function—specifically, left ventricular ejection fraction (LVEF)—in childhood cancer survivors.
Researchers found no difference in average LVEF measurement between Vivio and CMR—56.8 percent vs. 56.5 percent, respectively—in a study involving 191 patients who had been exposed to anthracycline chemotherapy. Results were published in the July issue of the journal Clinical Cancer Research.
Anthracycline-induced cardiotoxicity can cause irreversible heart failure. Consequently, after the completion of their chemotherapy, childhood cancer survivors are recommended to undergo screening for the detection of heart dysfunction.
While CMR imaging is considered the gold standard, it is expensive and is not widely accessible. However, the wireless device from Avicena collects pulse waves and phonocardiogram data from the carotid artery, which is transmitted to a smartphone or tablet, and leverages an algorithm that measures LVEF, which is commonly used to assess heart function.
According the co-authors of the study—some of whom hold equity, employment agreements and consulting agreements with Avicena—Vivio eliminates the need for result interpretation and enables real-time monitoring of heart health.
“This accessible technology has the potential to change the day-to-day practice of clinicians caring for the large number of patients diagnosed with cardiac dysfunction and heart failure each year, allowing real-time monitoring and management of their disease without the lag-time between imaging and interpretation of results,” researchers conclude.
Saro Armenian, DO, lead author and director of the Childhood Cancer Survivorship Clinic at the City of Hope in Duarte, Calif., notes that Vivio was developed by students and engineers at Caltech, who then founded Avicena.
“Vivio obviates the need for childhood cancer survivors to be physically seen at a medical center to undergo cardiac assessments, which can be done remotely,” says Armenian, who emphasizes that the device is not meant to replace echocardiography or CMR imaging, which both generate images of the heart and provide a more comprehensive assessment of cardiac health. “It’s meant to be a preliminary screening so that we can potentially identify individuals who need closer surveillance and monitoring.”
According to Armenian, although 90 percent of long-term cancer survivors—individuals surviving more than five years after their initial diagnosis—are actively engaged in regular medical care, fewer than 30 percent undergo routine recommended risk-based screening.
“We need a method to facilitate the population-based screening that is being underperformed in these cancer survivors,” he observes. “This study is the first step in thinking about new paradigms of long-term monitoring and care delivery for cancer survivors who are at risk for severe and life-threatening health conditions. It's important to think about more proactive and convenient approaches for early detection, early surveillance and early prevention to help potentially reverse heart disease before it becomes clinically apparent in this population.”