A novel, non-invasive AI-based telemonitoring system for heart failure: detection of undiagnosed hyperthyroidism in an asymptomatic patient

Authors

• Allan Böhm Premedix Academy, Bratislava, Slovakia; Third Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
• Julia Lucka Premedix Academy, Bratislava, Slovakia; Department of General Cardiology, The National Institute of Cardiovascular Diseases, Bratislava, Slovakia
• Amitai Segev Premedix Academy, Bratislava, Slovakia; The Leviev Cardiothoracic & Vascular Center, Chaim Sheba Medical Center, Ramat Gan, Israel
• Marta Kollarova Premedix Academy, Bratislava, Slovakia
• Stefan Toth Premedix Academy, Bratislava, Slovakia; Pavol Jozef Šafárik University in Kosice, 1st Department of Internal Medicine, Kosice, Slovakia
• Nikola Jajcay Premedix Academy, Bratislava, Slovakia; Institute of Computer Science Czech Academy of Sciences, Department of Complex Systems, Prague, Czech Republic
• Branislav Bezak Premedix Academy, Bratislava, Slovakia; Department of Cardiac Surgery, The National Institute of Cardiovascular Diseases, Bratislava, Slovakia

allan.bohm@premedix.org

Keywords

Abstract

Background: Untreated thyroid disorders may precipitate heart failure (HF) decompensation. Assessment of cardiac filling pressures may aid in the early detection and prevention of clinical decompensation. Therapy guided by monitoring of cardiac filling pressures has been shown to improve quality of life and survival and reduce hospitalizations of individuals with HF. We have developed a non-invasive method to assess left ventricular filling pressures (LVFP) by analysing the photoplethysmography signal with Seeling HeartCore technology (Seerlinq, Bratislava, Slovakia).
Case description: A 99-year-old female visited the clinic for a routine cardiac check-up. Laboratory investigations showed elevated NTproBNP and moderately elevated high sensitive troponin T. HeartCore algorithm indicated elevated LVFP. As part of the evaluation of worsening of sub-clinical HF, extended laboratory tests revealed low thyroid-stimulating hormone with high free thyroxine levels indicating increased thyroid function. The endocrinologist diagnosed hyperthyroidism with multinodular goitre and prescribed thiamazole. To prevent progression to clinical HF decompensation, the dose of furosemide was increased. At 4 months, during scheduled cardiac follow-up, the patient was clinically doing well, without any signs or symptoms of HF.
Discussion: Remote monitoring devices that track pressures in the pulmonary artery require invasive implantation and are associated to potential complications. The high cost of these devices presents a significant barrier to widespread use. SEERLINQ is a novel system for remote haemodynamic monitoring based on non-invasive assessment of LVFP, presenting a promising alternative to current invasive methods.
Conclusion: This case underscores the potential benefits of this technology in the early recognition of pre-clinical deterioration and its implementation for remote home monitoring in patients with HF.

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