Early detection of Congestive Heart
Failure using Smartphones
Problem
Heart Failure a major cause of fatality
3.top cause of fatality
Top reason for hospitalization
Costly and time consuming tests
ca. 445.000 hospitalizations recorded in 2015
ca. 50.000 cases/year
Costs: 3,2 Billion € at an estimated 2,7 Mio cases
Idea
Hospitalizations could be avoided
Need amulatory care and monitoring
Top reason for hospitalization
Costly and time consuming tests
> 1 Mio hospitalizations every year
Average annual number of emergency calls per doctor : 48 (courtesy BARMER GEK 2009)
Researchers have long considered CHF to be an ambulatory care sensitive condition (ACSC).
Hospitalizations of patients with ACSCs could often be avoided if these patients received
timely and appropriate medical care in outpatient settings
Costs: 30.7 Billion $ to the nation at an estimated 5.7 Mio cases
In the developed western countries it takes up about 1-2% of the Health Care budget
Market size
CHF Patient
readmissions
1 in 4 rehospitalized for
heart failure within 30 days
Average hospitalization
€1.5k
Average cost of
hospitalization per day
€15 B
Addressable market
600k
Heart attack survivors
alone in US
1 of 4 patients develop
CHF within 4 years of first
attack
€1.5k
Average cost of
hospitalization per day
€900 M
Addressable market
Heart attack
survivors
Solution
Our Maneuver
Valsalva Maneuver via Smartphone and Zencorlabs Manometer
Start the App and hold a
Finger in front of the
camera and flash of the
Smartphone.
The patient now blows in
the Zencor-Manometer for
20 seconds.
(with 40 mmHg = 0,05 bar)
*USPTO provisional patent application number 61481196
Solution
Maneuver’s Results
Findings : Estimation of Left Ventricular End Diastolic Pressure (LVEDP)
*USPTO provisional patent application number 61481196
Solution
A personal Database
Uniform and repeatable Tests via Smartphone
With the help of a Smartphone the patient could record the health of his heart .
The recorded data is continuously uploaded to the server, and an AI analysis is
instantly delivering the result to the user.
This enables Zenor-App to alert the patients of an approaching Heart Failure.
Technological Background
Valsalva Maneuver
Valsalva Maneuver,
effects on the Cardiovascular System
Antonio Maria
Valsalva (1666-1723)
Healthy Congestive heart
Effects on Blood pressure and Heart beat
Source: https://www.ncbi.nlm.nih.gov/pubmed/9641185
Maneuver with an empty
Syringe in a hospital
Technology
Proven principles
Clinical trials from John Hopkins Institute USA
1. Test February 2013 with 14 Subjects: 78% Sensitive , 100% Specific
Source: Link
2. Test April 2016 mit 81 Personen: 70% Sensitive , 86% Specific
Source: Link1, link2
A NONINVASIVE HAND-HELD DEVICE IDENTIFIES ELEVATED LEFT VENTRICULAR FILLING PRESSURE
USING FINGER PHOTOPLETHYSMOGRAPHY DURING THE VALSALVA MANEUVER
Technologie
Accuracy of Diagnosis
Accuracy
False
Alarm
Detection
ECG
30%
80%
Stress
Test
28%
67%
Dynamic
Auscultation
9%
70%
Zencorlabs
9%
70%
Blood
Test
26%
90%
Echo
Cardiography
6%
80%
Left heart/Pulmonary
catheterization
4%
96%
Product
Zencorlabs Version
Free App for the
Smartphone
Zencor Manometer for
ca 20 - 30 €
Result:
maximum coverage
minimum price
Affordable price !!!
Product
Zencorlabs Version
Quick check at Doctor’s office
Potential
Prevention and Control
Heart Failure
follow up
Autonomic nervous
system test
SVT treatment
Atrial Fibrillation
test
Hypertension
control
Revenue Model
Revenue
Market Customer Test Context Billing methods
B2C Primary care Non invasive LVEDP
test
Early Heart Failure
detection
CPT 93799
B2C Ambulance SVT treatment Revert Valsalva
Maneuver
Emergency inventory
(Australia)
B2C Primary care CARTs - Cardiac
Autonomic Reflex
HRV, E/I Ratio, Valsalva
Ratio, 30:15 test
CPT 95921
CPT 95943
B2B Pharma Non-Clinical
Cardiovascular
Safety Testing
Cardiac safety tests for
Antidepressant agents
Entry Fee +
Subscription
B2C Home
monitoring
Daily Zencoreye
monitoring + LVEDP
Follow up after Acute
Myocardial Infarction
Over The Counter
(patient is paying)
AliveCor
(FDA)
Cardiio
Quardio
(FDA)
Clarius
(FDA)
Cardiogram
MyHeart Counts
Preventicus
(CE Mark)
MyTheraphy
USA Europa
Competitive analysis
Disruptive Technologies
Growing mobile application space
Maisense
Viatom
cordio-med
Asia
Cnoga Medical
Blumio
Fibricheck
(CE Mark)
Cardio Secur
(CE Mark)
Scanadu
heartkinetics
Company Placement Sensing
technology
BP
technology
Valsalva
Maneuver
Price
fingertip PPG continuous no 20K $
fingertip PPG+ECG continuous yes 15K $
arm sonar continuous no 400 $
wrist PPG+ECG spot no 300 $
fingertip piezo+ECG spot no 400 $
fingertip PPG spot yes 250 $
fingertip mobile camera spot no ???$
fingertip mobile camera relative
continuous
yes 30 $
Competitive analysis
Quick comparison
Current Status
Prototype II: Clinical study
Current: Prototype 2
· Technology exists
· The devices are in production
· Next step: Clinical trial
Prototype 1
· Technical validation
zencorlabs
Team
System engineering &
Artificial Intelligence
Albert Bravo
Founder & CEO
Larion Rotrib
Co-Founder
Android & Web
Architect
Server Architect
Mohammed Amjed
Co-Founder
Prof at Med-Uni of Warsaw and a
gifted entrepreneur
Dr Łukasz Kołtowski
Clinical Partner