Heart Failure

Deliver a Continuum of Care from Hospital to Home

with Digital Vascular Biomarkers

Fast Fact

# 1 

#1 cause of hospitalizations in the Medicare population.1

Interconnection Between Heart Failure and Arterial Stiffening

  • Anastasio F, Testa M, Ferreri C, Rossi A, Ruocco G, Feola M.

    An abnormal increase in large arterial stiffness increases the workload on the heart and deteriorates ventricular compliance and ventricular–arterial coupling, leading to the progression of cardiac dysfunction.

    Anastasio F, Testa M, Ferreri C, Rossi A, Ruocco G, Feola M.
    Journal of Clinical Medicine
  • Ali D, Tran P, Ennis S, et al.

    PWV‐based arterial stiffness was found to be independently associated with the degree of LV hypertrophy (LVH), diastolic dysfunction, and NT‐proBNP irrespective of BP, BMI, and renal function.

    Ali D, Tran P, Ennis S, et al.
    ESC Heart Failure
  • ElGuindy A, Yacoub MH.

    LV diastolic dysfunction – namely impaired myocardial relaxation and increased stiffness – is the hallmark of HFpEF.

    ElGuindy A, Yacoub MH.
    Global Cardiology Science & Practice

Heart Failure and Arterial Stiffness

Arterial stiffness increases the workload on the heart by elevating central blood pressure and pulse pressure, contributing to the progression of heart failure. This increased hemodynamic load exacerbates the heart's inability to pump effectively, leading to further deterioration of cardiac function. Conversely, heart failure can accelerate arterial stiffness due to chronic inflammation, neurohormonal activation, and structural changes in the vasculature.
Research Highlights

Home-Centered Heart Failure Management

Vascular biomarkers, particularly central blood pressure (cBP), provide critical insights into arterial stiffness and wave reflections, offering a more accurate measure of the pressure experienced by the heart and central arteries compared to peripheral blood pressure. Regularly monitoring cBP enables clinicians to detect early signs of worsening heart failure and make timely adjustments to treatment plans.

Additionally, cBP measurements support a comprehensive approach to managing heart failure. The integration of remote cBP monitoring within a "hospital at home" model allows patients to receive hospital-level care and track their condition at home, promoting adherence to treatment and reducing hospital readmissions.

Utility of Vascular Biomarkers in Heart Failure Management

  • Anastasio F, Testa M, Ferreri C, Rossi A, Ruocco G, Feola M.

    The non-invasive measurements of arterial stiffness proved to be strong prognostic parameters in HF patients discharged after an acute HF decompensation.

    Anastasio F, Testa M, Ferreri C, Rossi A, Ruocco G, Feola M.
    Journal of Clinical Medicine
  • Wohlfahrt P, Melenovsky V, Redfield MM, et al.

    Increased aortic pressure wave pulsatility and greater decrease in pulsatility on treatment are associated with functional improvement in patients with HFrEF receiving aggressive vasodilator titration. These differences are not identifiable using brachial cuff pressures. Central aortic waveform analysis may enable better individualization of vasoactive therapies in chronic HFrEF.

    Wohlfahrt P, Melenovsky V, Redfield MM, et al.
    Cirulation: Heart Failure
  • Ali D, Tran P, Ennis S, et al.

    Reflecting a pulsatile arterial afterload associated with diastolic dysfunction and exercise capacity, PWV may provide a clinically relevant tool to identify at‐risk intermediate phenotypes (e.g. pre‐HFpEF) before overt HFpEF occurs.

    Ali D, Tran P, Ennis S, et al.
    ESC Heart Failure

Vascular Biomarkers Explained

Vascular biomarkers are revolutionizing not only cardiovascular health management but also clinical research and personal wellness strategies.

These critical indicators offer a comprehensive evaluation of the cardiovascular system's health across a broad spectrum, from clinical trials to individual health monitoring. By assessing key markers such as endothelial function, arterial stiffness, and coronary flow reserve, they enable a nuanced understanding of cardiovascular risks and conditions.

This valuable insight facilitates early intervention, personalized health optimization, and the development of targeted treatments in clinical settings, significantly advancing patient care and wellness initiatives.

Brachial Blood Pressure

What it Is
Brachial blood pressure measures the pressure of blood at the brachial artery using a blood pressure cuff.

Why it Matters
High blood pressure is a major risk factor for heart disease and stroke, both of which are leading causes of death in the US.

Central Blood Pressure

What it Is
Calculated using pulse wave analysis and a traditional brachial cuff, central blood pressure measures pressure at the root of the aorta.

Why it Matters
Central blood pressure reflects key vascular issues such as arterial stiffness, which makes it a more accurate predictor of subclinical cardiovascular disease than traditional brachial blood pressure alone.

Subendocardial Viability Ratio

What it Is
Subendocardial viability ratio measures the supply of blood that flows to your inner heart muscle in relation to demand.

Why it Matters
SEVR offers insight into how well a person’s heart can handle the stress of exercise.

Augmentation Pressure

What it Is
Augmentation pressure refers to the increase in central aortic pressure caused pressure wave reflection.

Why it Matters
A marker of arterial stiffness, elevated augmentation pressure is associated with cardiovascular risk factors as well as increased cardiovascular morbidity and mortality.

Augmentation Index

What it Is
An indirect measure of arterial stiffness that increases with age, augmentation index reflects the burden stiff arteries place on the heart.

Why it Matters
Chronic stress on the heart and the cardiovascular system can lead to heart failure and hypertrophy (enlarged heart).

Central Pulse Pressure

What it Is
The height of pressure at the heart, central pulse pressure shows the pressure to which key organs like the heart, brain, and kidneys are exposed.

Why it Matters
Central pulse pressure helps identify the risk of end organ damage to key organs like the brain, kidney and heart.

Medical Grade Heart Rate
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Pulse Wave Velocity

What it Is
Pulse wave velocity measures arterial stiffness.

Why it Matters
Increases in arterial stiffness are generally based on the loss of elasticity in the aorta artery walls over time and increases the strain on the heart from heightened pressures. Increased aortic stiffness using PWV is a validated predictor of cardiovascular events and all-cause mortality.

 
cbpCentral Blood Pressure

What it Is
Calculated using pulse wave analysis and a traditional brachial cuff, central blood pressure measures pressure at the root of the aorta.

Why it Matters
Central blood pressure reflects key vascular issues such as arterial stiffness, which makes it a more accurate predictor of subclinical cardiovascular disease than traditional brachial blood pressure alone.

 
bbpBrachial Blood Pressure

What it Is
Brachial blood pressure measures the pressure of blood at the brachial artery using a blood pressure cuff.

Why it Matters
High blood pressure is a major risk factor for heart disease and stroke, both of which are leading causes of death in the US.

 
sevrSubendocardial Viability Ratio

What it Is
Subendocardial viability ratio measures the supply of blood that flows to your inner heart muscle in relation to demand.

Why it Matters SEVR offers insight into how well a person’s heart can handle the stress of exercise.

 
medical grade heart rateMedical Grade Heart Measurement

What it Is
A beat-to-beat heart rate measurement on par with standard ECG-based methods.

Why it Matters
A consistently high resting heart rate may be a sign of coronary heart disease and is associated with a greater risk of stroke.

 
cppCentral Pulse Pressure

What it Is
The height of pressure at the heart, central pulse pressure shows the pressure to which key organs like the heart, brain, and kidneys are exposed.

Why it Matters
Central pulse pressure helps identify the risk of end organ damage to key organs like the brain, kidney and heart.

 
cppPulse Wave Velocity

What it Is
Pulse wave velocity measures arterial stiffness.

Why it Matters
Increases in arterial stiffness are generally based on the loss of elasticity in the aorta artery walls over time and increases the strain on the heart from heightened pressures. Increased aortic stiffness using PWV is a validated predictor of cardiovascular events and all-cause mortality.

 
augmentation pressureAugmentation Pressure

What it Is
Augmentation pressure refers to the increase in central aortic pressure caused pressure wave reflection.

Why it Matters
A marker of arterial stiffness, elevated augmentation pressure is associated with cardiovascular risk factors as well as increased cardiovascular morbidity and mortality.

 
augmentation indexAugmentation Index

What it Is
An indirect measure of arterial stiffness that increases with age, augmentation index reflects the burden stiff arteries place on the heart.

Why it Matters
Chronic stress on the heart and the cardiovascular system can lead to heart failure and hypertrophy (enlarged heart).

Hover over each biomarker above to learn more

Incorporate Vascular Biomarkers into Heart Failure Management

Download Reimbursement Guide

In-Clinic

  • Provide a thorough evaluation of the patient's cardiovascular health to enable precise risk stratification and individualized heart failure management.
  • Establish a protocol for consistent follow-up appointments and re-assessment to adjust heart failure treatment plans as the patient's vascular status changes.
  • Reimbursable with CPT 93050.

At Home

  • Conduct regular measurements to continuously monitor and manage from home, providing real-time data to inform treatment adjustments.
  • Utilize telemedicine to facilitate continuous interaction between patients and providers, ensuring personalized and responsive heart failure care.
  • Reimbursable with CPT 9945x & 99091.

SphygmoCor® XCEL

Capture comprehensive central hemodynamics and arterial stiffness insights at point-of-care and in clinical trials.

Explore XCEL

CONNEQT Pulse

Monitor arterial health insights with ease at home and on-the-go.

Explore Pulse

Oscar 2

Gold standard in 24-hour central hemodynamics and ambulatory blood pressure monitoring (ABPM).

Explore Oscar 2

1 Heart Failure Society of America

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