Advances in Heart Failure Monitoring and Treatment

Frost & Sullivan estimates the global congestive heart failure therapy market will be valued at more than $4.5 billion by 2022. A lucrative and fast-growing market for devices for the diagnosis and monitoring of heart failure is expected to have a similar, if not higher, value. Here are some companies that have developed innovative solutions for monitoring and managing heart failure

Heart failure is the heart’s inability to pump sufficient blood to cater to the body’s needs. The U.S. Centers for Disease Control and Prevention estimates that 5.7 million Americans are living with the condition. Common causes include coronary artery disease, high blood pressure and other cardiovascular diseases, and excessive alcohol intake; which part of the heart fails determines the course of disease progression and the consequences the patient faces.

In the case of left-sided failure, the heart fails to pump oxygenated blood into systemic circulation, which causes the blood to flow back into the lungs and congest them. Right-sided failure typically is caused by pulmonary heart disease or the existence of left-sided failure. In such cases, the heart fails to pump deoxygenated blood into the right ventricle and then to the lungs, which results in the “used” blood backing up into the veins. A third type of heart failure is congestive heart failure (CHF), wherein deoxygenated blood that has been stagnating in the veins is soaked up by surrounding tissues, typically in the lower extremities. This is characterized by swelling in the legs and shortness of breath, and calls for immediate medical attention. In fact, “CHF” and “heart failure” are often used interchangeably, since CHF is the ultimate manifestation of the failure of pulmonary circulation. A patient suffering from heart failure of any kind experiences shortness of breath, excessive fatigue and irregular heartbeat.

Frost & Sullivan, in its study of the global cardio-metabolic diseases industry, estimates the global CHF therapy market will be valued at more than $4.5 billion by 2022. A lucrative and fast-growing market for devices for the diagnosis and monitoring of heart failure is expected to have a similar, if not higher, value. Frost & Sullivan has profiled a number of companies and research organizations that have developed innovative solutions for monitoring and managing heart failure. A few notable accomplishments are summarized below.

Collaborative Cloud-based Heart Failure Monitoring System by Vixiar Medical (Annapolis, Md.)

Vixiar Medical’s flagship product, Indicor, is a non-invasive, point-of-care device for assessing the cardiac filling pressure—an indicator of cardiac performance. Vixiar follows the Valsalva maneuver, which is the practice of forced expiration while keeping the nose pinched and the mouth closed, to induce changes in pulse pressure believed to reflect cardiac filling pressures. A pulse oximeter component of the Indicor device is attached to the patient’s fingertip, capturing the changes in pulse pressure as the patient performs the maneuver. The device is tethered to a smartphone and records the readings onto a cloud-based platform, which can then be used to track, monitor and analyze the patient’s cardiac health.

Implantable Neuromodulation Therapies for Heart Failure (CVRx, Maple Grove, Minn.)

CVRx has developed an implantable neurostimulation device for managing cardiovascular diseases such as hypertension and CHF. The product, Barostim Neo, features a pulse generator that is implanted below the collarbone, an electrode that connects it with the carotid artery, and an external wireless control. The electrode stimulates baroreceptors that are located on the surface of the carotid artery. These baroreceptors pass the electrical signals to the brain, which in turn regulates the cardiovascular system, minimizing heart failure symptoms. The external programmer is used to control the conditions for stimulation during and after implantation. 

Regenerative Therapy for Heart Failure by Avery Therapeutics (Chandler, Ariz.)

Avery Therapeutics’ regenerative heart therapy is called MyCardia. The tissue-engineered graft was developed at the University of Arizona in Tucson, and Avery is commercializing it. MyCardia is a bioabsorbable scaffold that is coated with active human neonatal fibroblasts (cells that produce collagen and other fibers that are essential components of connective tissues) and stem cell-derived cardiomyocytes (precursor cells to cardiac tissues). When the graft is implanted on the surface of a diseased heart, the scaffold helps repair damaged heart muscles and stimulates local blood circulation.

The Road Ahead

The miniaturization of implantable devices and the emergence of wearable devices will strongly influence CHF diagnosis and monitoring. The predominant approach is to impart wireless communications to cardiac monitors so that they can be used for continuous and remote patient monitoring. India-based Jana Care is already piloting smartphone-based apps for CHF screening. On the therapy side, regenerative medicine—predominantly the use of stem cells and engineered tissues—is the focus of extensive research. San Diego-based Renova Therapeutics is among several companies conducting clinical trials to evaluate gene therapy options to treat heart failure.

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