A Point-of-Care Measurement of NT-proBNP for Heart Failure Patients

Abstract

Heart Failure (HF) diagnosis, subsequent admissions, and possible readmissions present challenges for health systems worldwide. An increasing number of patients within an ageing population are surviving cardiac conditions which can leave them with residual heart function impairment. Follow-up visits of either confirmed HF sufferers or HF high-risk patients could be reduced through the implementation of Point-of-Care (PoC) measurement of N-terminal pro-B-type natriuretic peptide (NT-proBNP), an inactive signal portion of the active hormone BNP that is released in response to cardiac wall stretch. Serial measurements of NT-proBNP concentration may serve to indicate progress/deterioration of HF sufferers which in turn indicates the quality of the interventions designed to treat HF. We present an integrated PoC solution that involves the user-friendly, low volume sampling of blood directly into a single-use sampling key with an integral NT-proBNP biomarker detection strip operating on a lateral flow immunoassay principle. When inserted into a corresponding portable electronic reader it forms an integrated detection and measurement platform that wirelessly communicates measurements (Wi-Fi) for cloud-based reporting, trending and data analysis. The system provides a practical, inexpensive support tool for HF management by informing those involved in clinical decision-making with necessary biomarker data. The PoC NT-proBNP measurement compares well against alternative technologies based on image analysis.

A Novel Method for Quantitative Analysis of C-Reactive Protein Lateral Flow Immunoassays Images via CMOS Sensor and Recurrent Neural Networks

“…Current setup using the green LEDs was designed specifically for LFA (hsCRP) used in the paper as to maximise the absorption of light photons by the gold nanoparticles at 530nm. The same setup (with green lights) can still be used with other LFA strips not using gold nanoparticles (such as in our study based on LFA with NT-proBNP for heart failure [43] ), but may result in some reduced sensitivity. Alternatively, the LEDs can be changed from green to white light source to have uniform lightning throughout the visible spectrum, allowing the system to be used for multiple strips, which is currently under development.…”

Point-of-Care Monitoring of Respiratory Diseases Using Lateral Flow Assay and CMOS Camera Reader

“…An LFA is a simple, user-friendly and low-cost rapid test device used to identify the presence of a target substance from small quantities of patient biological samples [1] , [2] attributed to different medical health conditions. Multiplex LFAs can also be designed to measure concentrations of multiple target substances simultaneously [3] .…”

“…Laboratory-based analysis tools can be sensitive with high accuracy but can also be expensive, not user-friendly and difficult to use in a PoC application. Alternative devices could use simple and low-cost light-sensitive measurement [1] or a mobile phone to take and analyse an image [2] . However, these methods would be sensitive to the mechanical alignment of the LFA with the sensors and external light conditions.…”

“…NEATstik® is a CE registered PoC device that provides a qualitative measurement of active NE in sputum. The process of using NEATstik® to measure NE is similar to other LFA used in several different PoC implementations [1] . Although the existing iteration may have a role to play in routine patient monitoring, a quantitative version would provide greater objectivity during use.…”

“…Therefore any monitoring of the patient’s health is difficult and inaccurate, particularly at the lower concentrations where changes in the Test Line intensity is not clearly visible in the images. The paper aims to develop a suitable NEATstik® reader, similar to other LFA readers [1] , to provide a quantitative approach to estimate the patient’s NE concentration. A historical log of the patient’s measured NE concentration can be used to track changes during the treatment period and tailor the medications to improve the patients quality of living.…”