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Cardisiography including AI-based ischemia and heart failure screening!
Heart failure screening in primary diagnostics is possible with cardisiography!

Heart failure (HF) is a clinical syndrome characterized by typical symptoms and signs (e.g., shortness of breath, fatigue, leg swelling, and reduced physical capacity). These complaints are caused by structural or functional cardiac alterations that reduce cardiac output and increase intracardiac pressures [1].

The most common causes of heart failure include coronary artery disease, myocardial infarction, arterial hypertension, atrial fibrillation/arrhythmias, valvular heart disease, myocarditis, cardiomyopathies (e.g., cardiac amyloidosis, dilated cardiomyopathy), certain medications (e.g., chemotherapeutic agents), and excessive alcohol consumption [2,3].

In Germany, approximately 4 million people are affected by chronic heart failure [4]. According to the Federal Statistical Office, the direct healthcare costs for all diseases in Germany amounted to about 491.6 billion euros in 2023 [5]. Of these total costs, cardiovascular diseases accounted for around 64.6 billion euros, approximately 13.1 % of all disease-related costs [6].

After a diagnosis of heart failure, the one-year survival rate is roughly 75–80 % [7, 8], and the five-year survival rate is about ≈ 50 % [9, 10].

Therefore, early diagnosis is crucial to initiate appropriate treatment in time and to reduce morbidity and mortality. However, diagnostics are often challenging because cardiac changes typically develop gradually and subtly [11]. Non-invasive procedures such as echocardiography and cardiac magnetic resonance imaging (MRI) play a central role in early detection [3,12], but they are often associated with high costs, long waiting times, and the need for specialized personnel. Thus, there is a need for faster, more cost-effective, and more accessible non-invasive testing methods such as cardisiography to detect functional and structural changes of the heart.

Cardisio has developed a modified vectorcardiography (VCG) approach that has the potential to provide more comprehensive spatial and temporal information on the heart’s electrical activity [13]. So far, we have been able to identify parameters that enable the detection of patients with reduced left ventricular ejection fraction as well as left ventricular hypertrophy. The results were presented at the annual meeting of the German Society of Cardiology in April 2025.

What is included in a cardisiography report?

  • Ischemia Index (CSG Ischemia Index / “P”)
  • Structural Heart Disease Index (CSG-SHD / “S”)
  • Arrhythmia Index (A)

In addition, we are working on defining specific parameters to detect patients with cardiac amyloidosis and other conditions within the spectrum of heart failure. Our goal is to develop a reliable tool that supports decision-making, helps identify heart failure patients at an early stage, guides them efficiently into the appropriate diagnostic-therapeutic pathway, and avoids unnecessary referrals to specialists.

 

1. Ibănescu R, Mîțu DA, Goje ID, Goje GI, Lighezan D, History of Heart Failure Definition. Cardiac Failure Review 2025;11:e07. https://doi.org/10.15420/cfr.2024.22
2. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. (May 2022). “2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines”. Journal of the American College of Cardiology. 79 (17): e263 – e421. doi:10.1016/j.jacc.2021.12.012
3. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. (September 2021). “2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure” (PDF). European Heart Journal. 42 (36): 3599–3726. doi:10.1093/eurheartj/ehab368
4. https://herzstiftung.de/service-und-aktuelles/presse/pressemitteilungen/herzbericht-update-2024-herzschwaeche
5. https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Gesundheit/Krankheitskosten/_inhalt
6. https://www.aok.de/gp/news-reha-vorsorge/newsdetail/anhaltend-hohe-kosten-fuer-kreislauferkrankungen-und-psychische-stoerungen)
7. McDonagh TA, Metra M, Adamo M et al. 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). European Heart Journal, Volume 44, Issue 37, 1 October 2023, Pages 3627–3639, https://doi.org/10.1093/eurheartj/ehad195
8. Thorvaldsen T, Benson L, Dahlström U, Edner M, Lund LH. Use of evidence-based therapy and survival in heart failure in Sweden 2003-2012. Eur J Heart Fail. 2016 May;18(5):503-11. doi: 10.1002/ejhf.496. Epub 2016 Feb 11. PMID: 26869252.
9. Ho KK, Anderson KM, Kannel WB, Grossman W, Levy D. Survival after the onset of congestive heart failure in Framingham Heart Study subjects. Circulation. 1993 Jul;88(1):107-15. doi: 10.1161/01.cir.88.1.107. PMID: 8319323.
10. Pocock SJ, Ariti CA, McMurray JJ, Maggioni A, Køber L, Squire IB, Swedberg K, Dobson J, Poppe KK, Whalley GA, Doughty RN; Meta-Analysis Global Group in Chronic Heart Failure. Predicting survival in heart failure: a risk score based on 39 372 patients from 30 studies. Eur Heart J. 2013 May;34(19):1404-13. doi: 10.1093/eurheartj/ehs337. Epub 2012 Oct 24. PMID: 23095984.
11. Wang H, Gao C, Guignard-Duff M, Cole C, Hall C, Larman M, et al. Importance of early diagnosis and treatment of heart failure across the spectrum of ejection fraction. European heart journal. 2023;44(Supplement_2).
12. Arbelo E, Protonotarios A, Gimeno JR, Arbustini E, Barriales-Villa R, Basso C, et al. 2023 ESC Guidelines for the management of cardiomyopathies. European heart journal. 2023.
13. Braun T, Spiliopoulos S, Veltman C, Hergesell V, Passow A, Tenderich G, et al. Detection of myocardial ischemia due to clinically asymptomatic coronary artery stenosis at rest using supervised artificial intelligence-enabled vectorcardiography – A five-fold cross validation of accuracy. J Electrocardiol. 2020;59:100-5.

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