CardioWise connects cardiac CT data with innovative new artificial intelligence (AI) algorithms that augment human decision-making within existing clinical workflows

Tech Brief

The use of cardiac CT Angiography (CCTA) for patients is rapidly gaining international acceptance in the EU, UK and USA. In numerous clinical trials CCTA has shown its effectiveness at ruling out coronary syndromes in patients with chest pain, and it has superior sensitivity to the existence of coronary disease compared to Xray-angiography. The ROMICAT clinical trials have demonstrated that adding regional LV function results in a 10% increase in sensitivity to detect Acute Coronary Syndrome (ACS) by cardiac CT and significantly improved the overall accuracy. A concomitant accurate measurement of regional LV function over the entire left ventricle provides important clinical information that can be obtained easily during the same data acquisition and the same heartbeat using SQuEEZ. Resting wall motion abnormalities observed with CT in these subjects has been shown to increase the likelihood of ACS significantly. The acquisition of LV function with SQuEEZ during CCTA would eliminate the need for immediate diagnostic echo or SPECT in these patients if a wall motion abnormality is found which is combined with moderate to severe coronary lesion. Since LV function with SQUEEZ can be measured during the same heartbeat as the CCTA acquisition, it may be easily included as part of the exam with no more radiation dose. Today, the cost of diagnosis for a patient averages $3600 worldwide and requires 22-24 hours to complete. Use of CCTA with SQuEEZ would reduce the cost of diagnosis to $700 and would reduce the time required to obtain results to 2 hours.

Problem Tech Solves

There is presently no high resolution, 4D diagnostic imaging test that can deliver quantitative results to assess contractile (heart) function, the key to diagnosis for cardiovascular disease. CardioWise SQuEEZ™ indicates the presence and severity of an individual patient's pathologic cardiac dysfunction that is currently addressed using qualitative methods and surrogate tests. The ability to both quantify and localize the left ventricular contractile dysfunction will improve clinical outcomes by addressing limitations of the current non-quantitative metrics. SQuEEZ™ is an objective standard that will increase consistency and accuracy by reducing user variability that previously plagued echocardiographic interpretation of left ventricular function. This produces uncertainty in diagnosis and additional imaging tests are ordered, delaying interventions, reducing efficiency and increasing healthcare costs. Leveraging patented machine learning (ML) algorithms, CardioWise SQuEEZ™ software accepts cardiac CT imaging data sets in a highly-secure, cloud-based system that provides easy-to-interpret, quantitative images of heart function that can be transmitted to cardiologists and referring physicians. CardioWise’s SQuEEZ™ is the first ML solution that provides caregivers with cardiac CT data analysis in a single set of quantitative images needed to accurately and easily assess heart function thereby eliminating the need for additional testing. CardioWise's non-invasive Cardiac Computed Tomography (cCT) analysis software, SQuEEZTM, is uniquely capable of identifying those patients with heart function injury which is the top comorbidity factor for COVID-19. COVID-19 can cause severe heart damage from myocardial inflammation. SQuEEZ™ can help doctors quickly and accurately identify those patients who have the highest risk and thereby save lives.

Validation

There have been over 500 patients analyzed with SQuEEZ at 8 institutions with current clinical work continuing at University of California San Diego, Emory Univeristy, National Institutes of Health—National Heart Lung and Blood Institute and University of Maryland. There are 19 individual users based at these institutions who have used or who are using SQuEEZ. Among other users are Johns Hopkins Medicine, Kings College London, Guy's and St. Thomas' Hospital London, and University of Wisconsin. The studies have ranged over many different applications including studies of the right ventricle (RV) in adult congenital heart disease; evaluation of RV function for pulmonary embolisms and pulmonary hypertension; atrial appendage (atrial fibrillation), normal hearts database, comparison to MRI strain for validation; and treatment planning for heart failure patients who are scheduled for Cardiac Resynchronization Therapy (CRT) device implantation using the Image Toolbox product.