HFpEF detection using exertional heart sounds

Patent metadata

Field	Value
Publication number	US-11406283-B2
Application number	US-201916709382-A
Country	US
Kind code	B2
Filing date	Dec 10, 2019
Priority date	Dec 11, 2018
Publication date	Aug 9, 2022
Grant date	Aug 9, 2022

Abstract

This document discusses, among other things, systems and methods to determine an indication of heart failure with preserved ejection fraction (HFpEF) of a subject using a determined change in cardiac acceleration information of the subject at exertion relative to cardiac acceleration information of the subject at rest. The system can include a signal receiver circuit configured to receive cardiac acceleration information of a subject and exertion information of the subject, and an assessment circuit configured to determine the change in cardiac acceleration information of the subject at exertion relative to cardiac acceleration information of the subject at rest, and to determine an indication of HFpEF of the subject using the determined change in cardiac acceleration information.

First claim

What is claimed is:

1. A medical-device system, comprising:
a signal receiver circuit configured to receive exertion information of a subject and cardiac vibration acceleration information of the subject, the cardiac acceleration information comprising third heart sound (S 3 ) information of the subject; and
an assessment circuit configured to:
determine a period of rest of the subject using the received exertion information;
determine a period of exertion of the subject using the received exertion information;
determine a measure of cardiac acceleration information of the subject for the determined periods of rest;
determine a measure of cardiac acceleration information of the subject for the determined periods of exertion;
determine a change in magnitude or energy of the determined measure of cardiac acceleration information of the subject for the determined period of exertion relative to the determined measure of cardiac acceleration information of the subject at rest, and to for the determined period of rest;
determine an indication of heart failure with preserved ejection fraction (HFpEF) of the subject using the determined change in magnitude or energy of the determined measures; and

provide an output of the determined indication of HFpEF to a user interface for display to a user, or to another circuit to control or adjust a process or function of the medical-device system.

2. The system of claim 1 , wherein the cardiac acceleration information comprises the S 3 information of the subject and at least one of first heart sound (Si) information of the subject, second heart sound (S 2 ) information of the subject, or fourth heart sound (S 4 ) information of the subject, and
wherein the measure of cardiac acceleration information comprises a ratio of the S 3 information and at least one of the S 1 information, the S 2 information, or the S 4 information.

3. The system of claim 2 , wherein the S 1 information, the S 2 information, the S 3 information, and the S 4 information comprise a magnitude or energy of the respective information.

4. The system of claim 1 , wherein the assessment circuit is configured to:
trend determined measures of cardiac acceleration information of the subject for determined periods of rest;
trend determined measures of cardiac acceleration information of the subject for determined periods of exertion; and
determine the change in magnitude or energy of the determined measure of cardiac acceleration information of the subject for the determined period of exertion relative to the determined measure of cardiac acceleration information of the subject for the determined period of rest using the trends.

5. The system of claim 3 , wherein the signal receiver circuit is further configured to receive posture information of the subject, and
wherein the assessment circuit is configured to:
determine the period of rest of the subject using the received exertion information and the received posture information; and
determine the period of exertion of the subject using the received exertion information and the received posture information.

6. The system of claim 1 , wherein the assessment circuit is configured to:
trend determined changes in the determined measure of cardiac acceleration information of the subject for the determined period of exertion relative to the determined measure of cardiac acceleration information of the subject for the determined period of rest; and
determine the change in cardiac acceleration information of the subject using the trend.

7. The system of claim 1 , wherein the signal receiver circuit is configured to receive the cardiac acceleration information of the subject and the exertion information of the subject using the same acceleration sensor at different times, and
wherein the assessment circuit is configured to:
determine a level of exertion using acceleration information from the acceleration sensor;
detect a transition from a first exertion level to a second, lower exertion level;
determine, following the detected transition from the first exertion level to the second exertion level, a measure of cardiac acceleration information of the subject indicative of cardiac acceleration information of the subject at the first exertion level; and
determine, after a recovery period following the detected transition from the first exertion level to the second exertion level, a measure of cardiac acceleration information of the subject indicative of cardiac acceleration information of the subject at the second exertion level.

8. The system of claim 7 , comprising a posture sensor configured to sense posture information of the subject,
wherein the assessment circuit is configured to detect the transition from the first exertion level to the second, lower exertion level using the exertion information of the subject and the posture information of the subject.

9. The system of claim 7 , comprising the acceleration sensor configured to sense cardiac acceleration information of the subject and exertion information of the subject,
wherein the signal receiver circuit is configured to receive the cardiac acceleration information of the subject and the exertion information of the subject from the acceleration sensor, and
wherein the second exertion level is rest.

10. The system of claim 1 , comprising:
a cardiac acceleration sensor configured to sense the cardiac acceleration information of the subject; and
an activity sensor configured to sense exertion information of the subject,
wherein the signal receiver circuit is configured to receive the cardiac acceleration information of the subject from the cardiac acceleration sensor and the exertion information of the subject from the activity sensor.

11. The system of claim 1 , wherein the assessment circuit is configured to determine the indication of HFpEF of the subject using a determined change in cardiac acceleration information at exertion relative to cardiac acceleration information of the subject at rest greater than an HFpEF threshold.

12. The system of claim 1 , wherein, to determine the indication of HFpEF of the subject, the assessment circuit is configured to determine an indication of worsening HFpEF of the subject using the determined change in cardiac acceleration information, the system further comprising:
a user interface configured to provide a human-perceptible alert to the subject or a clinician using the determined indication of worsening HFpEF of the subject.

13. The system of claim 1 , wherein the assessment circuit is configured to distinguish between heart failure with reduced ejection fraction (HFrEF) and HFpEF using the determined change in magnitude or energy of the determined measures.

14. A method of controlling a medical-device system, comprising:
receiving exertion information of a subject and cardiac acceleration information of the subject using a signal receiver circuit, the cardiac acceleration information comprising third heart sound (S 3 ) information of the subject;
determining, using an assessment circuit, a period of rest of the subject using the received exertion information;
determining, using the assessment circuit, a period of exertion of the subject using the received exertion information;
determining, using the assessment circuit, a measure of cardiac acceleration information of the subject for the determined periods of rest;
determining, using the assessment circuit, a measure of cardiac acceleration information of the subject for the determined periods of exertion;
determining, using the assessment circuit, a change in magnitude or energy of the determin

Assignees

• Cardiac Pacemakers Inc

Inventors

• Thakur Pramodsingh Hirasingh
• Mi Bin

Classifications

• A61B5/7275

  Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor · CPC title

• A61B5/1118

  Determining activity level · CPC title

• A61B7/00 Primary

  Instruments for auscultation · CPC title

• A61B2562/0219

  Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches · CPC title

• A61B5/1102 Primary

  Ballistocardiography · CPC title