Vocal Biomarker Is Associated With Hospitalization and Mortality Among Heart Failure Patients

Abstract

Background The purpose of this article is to evaluate the association of voice signal analysis with adverse outcome among patients with congestive heart failure ( CHF ). Methods and Results The study cohort included 10 583 patients who were registered to a call center of patients who had chronic conditions including CHF in Israel between 2013 and 2018. A total of 223 acoustic features were extracted from 20 s of speech for each patient. A biomarker was developed based on a training cohort of non‐ CHF patients (N=8316). The biomarker was tested on a mutually exclusive CHF study cohort (N=2267) and was evaluated as a continuous and ordinal (4 quartiles) variable. Median age of the CHF study population was 77 (interquartile range 68–83) and 63% were men. During a median follow‐up of 20 months (interquartile range 9–34), 824 (36%) patients died. Kaplan–Meier survival analysis showed higher cumulative probability of death with increasing quartiles (23%, 29%, 38%, and 54%; P <0.001). Survival analysis with adjustment to known predictors of poor survival demonstrated that each SD increase in the biomarker was associated with a significant 32% increased risk of death during follow‐up (95% CI, 1.24–1.41, P <0.001) and that compared with the lowest quartile, patients in the highest quartile were 96% more likely to die (95% CI , 1.59–2.42, P <0.001). The model consistently demonstrated an independent association of the biomarker with hospitalizations during follow‐up ( P <0.001). Conclusions Noninvasive vocal biomarker is associated with adverse outcome among CHF patients, suggesting a possible role for voice analysis in telemedicine and CHF patient care.

Biomarker potential of real-world voice signals to predict abnormal blood glucose levels

“…Unstable pitch and loudness were observed in patients with multiple sclerosis 3 . Other recent studies also demonstrated distinct voice characteristics that were associated with various pathological, neurological, and psychiatric disorders, such as congestive heart failure 4 , Parkinson’s disease 5 , Alzheimer’s disease 6 , post-traumatic stress disorder 7 , and autism spectrum disorder 8 . The human voice is now considered as an emerging biomarker, which is inherently non-invasive, low-cost, accessible, and easy to monitor health conditions in various real-life settings.…”

Smart Wearables for Cardiac Monitoring—Real-World Use beyond Atrial Fibrillation

“…The measurement of vocal biomarkers shows a good correlation with the degree of pulmonary hypertension [ 142 ]. In patients with heart failure, vocal biomarkers correlate with heart failure hospitalizations and mortality [ 143 ]. In a proof-of-concept study, AI was able to ensure the contactless detection of cardiovascular arrests using smart speakers or smartphones and differentiate between agonal breathing and hypopnea, central apnea and obstructive apnea [ 144 ].…”

Innovation in Precision Cardio-Oncology During the Coronavirus Pandemic and Into a Post-pandemic World

“…Remote monitoring from wearable biosensors and mHealth is being investigated to improve outcomes in heart rhythm and heart failure and other cardiovascular conditions (44,(46)(47)(48)(49)(50), and may have utility for COVID-19 (19,(52)(53)(54)(55)(56)(57)(58) and Cardio-Oncology (59)(60)(61). Voice apps and voice analysis have shown promise in cardiology for heart failure, ischemic heart disease, pulmonary hypertension, and other forms of cardiovascular disease (45,(62)(63)(64), as well as cardio-oncology (65), and have been considered for COVID-19. Drones built on artificial intelligence are being used to deliver healthcare equipment, medicines, personal protective equipment, and food, especially to remote areas with high rates of illness with COVID-19, and are also being dispatched to dense urban locations to urge pedestrians to maintain social distancing (66)(67)(68).…”