Tracking clinical status for heart failure patients using ballistocardiography and electrocardiography signal features

Heart failure (HF) is an escalating public health problem, with few effective methods for home monitoring. In HF management, the important clinical factors to monitor include symptoms, fluid status, cardiac output, and blood pressure - based on these factors, inotrope and diuretic dosages are adjusted day-by-day to control the disorder and improve the patient's status towards a successful discharge. Previously, the ballistocardiogram (BCG) measured on a weighing scale has been shown to be capable of detecting changes in cardiac output and contractility for healthy subjects. In this study, we investigated whether the BCG and electrocardiogram (ECG) signals measured on a wireless modified scale could accurately track the clinical status of HF patients during their hospital stay. Using logistic regression, we found that the root-mean-square (RMS) power of the BCG provided a good fit for clinical status, as determined based on clinical measurements and symptoms, for the 85 patient days studied from 10 patients (p <; 0.01). These results provide a promising foundation for future studies aimed at using the BCG / ECG scale at home to track HF patient status remotely.

[1]  L Giovangrandi,et al.  Non-invasive cardiac output trending during exercise recovery on a bathroom-scale-based ballistocardiograph , 2009, Physiological measurement.

[2]  Sharon-Lise T. Normand,et al.  An Administrative Claims Measure Suitable for Profiling Hospital Performance on the Basis of 30-Day All-Cause Readmission Rates Among Patients With Heart Failure , 2008, Circulation. Cardiovascular quality and outcomes.

[3]  J. Concato,et al.  Patterns of Weight Change Preceding Hospitalization for Heart Failure , 2007, Circulation.

[4]  M. Packer,et al.  Proposal for a new clinical end point to evaluate the efficacy of drugs and devices in the treatment of chronic heart failure. , 2001, Journal of cardiac failure.

[5]  P Baiardi,et al.  Multicenter randomised trial on home-based telemanagement to prevent hospital readmission of patients with chronic heart failure. , 2009, International journal of cardiology.

[6]  Xuan Cai,et al.  Lifetime risk for heart failure among white and black Americans: cardiovascular lifetime risk pooling project. , 2013, Journal of the American College of Cardiology.

[7]  Mark V. Williams,et al.  Rehospitalizations among patients in the Medicare fee-for-service program. , 2009, The New England journal of medicine.

[8]  Y Wang,et al.  Readmission after hospitalization for congestive heart failure among Medicare beneficiaries. , 1997, Archives of internal medicine.

[9]  Mark D. Huffman,et al.  Heart disease and stroke statistics--2013 update: a report from the American Heart Association. , 2013, Circulation.

[10]  A. Negassa,et al.  Prognostic importance of weight loss in chronic heart failure and the effect of treatment with angiotensin-converting-enzyme inhibitors: an observational study☆ , 2003 .

[11]  Gregory T. A. Kovacs,et al.  Preliminary results from BCG and ECG measurements in the heart failure clinic , 2012, 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[12]  H. Krumholz,et al.  Telemonitoring in patients with heart failure. , 2010, The New England journal of medicine.

[13]  Gregory T. A. Kovacs,et al.  Noninvasive Measurement of Physiological Signals on a Modified Home Bathroom Scale , 2012, IEEE Transactions on Biomedical Engineering.

[14]  Richard M. Wiard,et al.  Robust ballistocardiogram acquisition for home monitoring , 2009, Physiological measurement.

[15]  B. Yawn,et al.  Trends in heart failure incidence and survival in a community-based population. , 2004, Journal of the American Medical Association (JAMA).

[16]  G. Fonarow,et al.  Home monitoring for heart failure management. , 2012, Journal of the American College of Cardiology.

[17]  I. Piña,et al.  Forecasting the Impact of Heart Failure in the United States: A Policy Statement From the American Heart Association , 2013, Circulation. Heart failure.

[18]  E. Wolfel,et al.  Can we predict and prevent the onset of acute decompensated heart failure? , 2007, Circulation.

[19]  Gregory T. A. Kovacs,et al.  Rapid Assessment of Cardiac Contractility on a Home Bathroom Scale , 2011, IEEE Transactions on Information Technology in Biomedicine.

[20]  Richard E. Rohr,et al.  Rehospitalizations among patients in the Medicare fee-for-service program. , 2009, The New England journal of medicine.