Non-invasive cardiac kinetic energy distribution: a new marker of heart failure with impaired ejection fraction (KINO-HF)

Abstract

BackgroundHeart failure (HF) remains a major cause of mortality, morbidity, and poor quality of life. 44% of HF patients present impaired left ventricular ejection fraction (LVEF). Kinocardiography (KCG) technology combines ballistocardiography (BCG) and seismocardiography (SCG). It estimates myocardial contraction and blood flow through the cardiac chambers and major vessels through a wearable device. Kino-HF sought to evaluate the potential of KCG to distinguish HF patients with impaired LVEF from a control group.MethodsSuccessive patients with HF and impaired LVEF (iLVEF group) were matched and compared to patients with normal LVEF ≥ 50% (control). A 60 s KCG acquisition followed cardiac ultrasound. The kinetic energy from KCG signals was computed in different phases of the cardiac cycle (iKsystolic;ΔiKdiastolic) as markers of cardiac mechanical function.ResultsThirty HF patients (67 [59; 71] years, 87% male) were matched with 30 controls (64.5 [49; 73] years, 87% male). SCG ΔiKdiastolic, BCG iKsystolic, BCG ΔiKdiastolic were lower in HF than controls (p < 0.05), while SCG iKsystolic was similar. Furthermore, a lower SCG iKsystolic was associated with an increased mortality risk during follow-up.ConclusionsKINO-HF demonstrates that KCG can distinguish HF patients with impaired systolic function from a control group. These favorable results warrant further research on the diagnostic and prognostic capabilities of KCG in HF with impaired LVEF.Clinical Trial Registration: NCT03157115.

Smartphone-Derived Seismocardiography: Robust Approach for Accurate Cardiac Energy Assessment in Patients with Various Cardiovascular Conditions

“…However, to our knowledge, there is no formal, thorough comparison between a validated device and a smartphone-derived SCG. Our study demonstrates that kinetic energy metrics derived from SCG computed on signals acquired with a device validated in previous studies [16,22] are comparable with an ICC on average greater than 0.8, as well as BA without trends and 92% within the limit of agreements for the different metrics. It is noteworthy that the measurement iK Late dia demonstrated the most significant level of variability, nearly surpassing the predefined boundaries of the limits of agreement.…”

“…These studies have helped understand the impact of cardiac diseases on intra-cardiac hemodynamics and explore new ways to characterize HF [27][28][29]. Building on these insights, two metrics were developed: the iK systolic (inspired by the LV systolic MRI kinetic energy) and the ∆iK diastolic, reflecting the diastolic phase's kinetic energy distribution [22]. Differences in iK metrics have been associated with differences in stroke volume, LVEF, and cardiac output in healthy subjects during a dobutamine-induced inotropic increase [30,31] and in heart failure patients [23].…”

“…This procedure is summarized in Figure 3. These metrics aim to reflect metrics previously computed based on an ECG segmentation [22]. For each record, the median iK Sys , iK Late dia , and iK Early dia of all the valid heartbeats within a record were computed and used to compare the records.…”

“…For each record, the median iK Sys , iK Late dia , and iK Early dia of all the valid heartbeats within a record were computed and used to compare the records. In previous publications [22,23], rotational kinetic energy was reported and analyzed. However, since it did not yield results that differed from those of linear kinetic energy, this parameter is not independently investigated in the current work.…”

Non-invasive technologies for heart failure, systolic and diastolic dysfunction modeling: a scoping review

“…Significant increases in the BCG iK and BCG Pmax over the cardiac cycle (CC) were found, while SCG iK and Pmax were revealed in a non-significant elevation. Another work confirmed that KCG have potential to detect HF patients ( De Keyzer et al, 2023 ), As SCG ΔiK diastolic, BCG ΔiK diastolic, and BCG iK systolic found to be significantly different between HF patients (EF < 50) and normal patients (EF ≥ 50).…”