Wireless device could detect heart dysfunction in childhood cancer survivors treated with chemo

A wireless device was comparable to cardiac MRI in accuracy when detecting heart dysfunction in childhood cancer survivors who were treated with anthracycline chemotherapy, according to a study published in Clinical Cancer Research.

Childhood cancer survivors are urged to undergo screening for the detection of heart dysfunction as a result of anthracycline-induced cardiotoxicity. However, screening with echocardiography can be highly variable and limited. In this study, researchers evaluated the feasibility of using a wireless prototype device to detect heart abnormalities in this population.

"The pediatric oncology community is becoming increasingly aware that there are new issues faced by many cancer survivors that may not manifest themselves until decades after their cancer treatment is done," said author Saro Armenian, DO, MPH, director of the Childhood Cancer Survivorship Clinic, and colleagues. "One of these issues is a higher burden of cardiovascular disease, which can result from exposure to anthracyclines [a class of chemotherapy] as part of their cancer treatment."

The protype handheld device, called Vivio, collects pulse waves and phonocardiogram data form the carotid artery. The data are then wirelessly sent to a mobile device where it can be interpreted. Vivio measures the left ventricular ejection fraction (LVEF) to collect measurements in detecting signs of abnormal heart function. The study included 191 patients who were diagnosed with cancer before 22 years of age, had completed their treatment at least two years prior and been exposed to anthracycline chemotherapy.

"This study is the first step in thinking about new paradigms of long-term monitoring and care delivery for cancer survivors who are at risk for severe and life-threatening health conditions," said Armenian. "It's important to think about more proactive and convenient approaches for early detection, early surveillance, and early prevention to help potentially reverse heart disease before it becomes clinically apparent in this population."

Results showed the average LVEF measurement form Vivio was comparable to cardiac MRI. Using cardiac MRI as the gold standard, Vivio achieved high sensitivity and a low false-negative rate for the identification of individuals with abnormal LVEF.

"One possible implementation of Vivio could be for preliminary screening," Armenian explained. "If the patient's heart function is below a specific threshold as measured by Vivio, that patient could schedule an in-depth evaluation. This way, Vivio could keep these survivors engaged and help to reduce the burden of inconvenient tests for individuals with a normal heart function as determined by the device.