Chronic Heart Failure
Management of the Chronic Heart Failure: Elaboration and Development of the New Method
Tech Area / Field
- MED-DID/Diagnostics & Devices/Medicine
3 Approved without Funding
Center for Coordination and Implementation of Scientific, Technological and Socio-Economic Projects, Georgia, Tbilisi
- Tbilisi State Medical University / Research Institute of Experimental and Clinical Medicine / National Center of Therapy, Georgia, Tbilisi\nGeorgian Society of Cardiology, Georgia, Tbilisi
- Vanderbilt University Medical Center, USA, TN, Nashville
Project summaryThe purpose of the project is the development and implementation in clinical practice of new non-invasive technology for early evaluation and adequate monitoring (management) of the chronic heart failure (CHF).
Heart failure has remained one of the most difficult medical conditions to manage throughout recorded medical history. Chronic heart failure -is a complex clinical syndrome being outcome of the majority of cardiovascular diseases. CHF - is the main reason of morbidity and mortality for the cardiovascular patient cohort. In USA the number of patients with CHF reaches 5 million persons (1,5-2%) and grows annually on 400-700 thousand, in Western Europe the amount of similar patients is about 10 million. Epidemiological data in Georgia are more dramatic due to social- economic background in country. The average cost of adequate therapy for these patients is too high. Therefore rational evaluation and treatment of CHF is a major problem of a modern cardiology. One of the greatest challenges in managing patient care results from the need for readily accessible, objective data that signals disease progression and/or treatment effectiveness. The main aim of the project is obtaining, recording and trending these data with new non-invasive technology, that produces valid, reproducible and cost-effective measurement of cardiovascular function in a timely manner. It will be effective in the assessment, diagnoses and evaluation of treatment outcomes.
It is well known, that heart, vascular wall and endothelium, and the system neurohormones are integrated in function to regulate the delivery of oxygen and blood to the tissues of the body. Disorders of the vascular wall and/or endothelium may alter the delivery of oxygen regionally or systemically through local release of vasoactive substances. Disorders of the heart affect systemic oxygen delivery directly and indirectly through activation of neurohormonal modulators (renin angiotensin aldosterone system, sympathetic nervous system), which exert their effects on both the heart and vascular wall/endothelium. That in turn, immediately influences heart, vascular wall and endothelium. The present concept of a blood circulation has the limitations in the understanding and measurement of the global, integral cardiovascular function. Until recently, in similar studies, only invasive techniques was used. However monitoring of main parameters, determining the amount of blood pumped (preload, contractility, heart rate and systemic vascular resistance) with invasive tests is increase cost containment efforts in dynamic management of CHF. Recently, the locus of care for patients with HF shifted from acute care to outpatient setting and the aim of their monitoring is to assess the disease severity, progression and treatment response. The development and evaluation of impedance cardiography (thoracic bioimpedance), specially adapted for measuring cardiac stroke volume, is now providing what appears to be a valid, accurate, and reproducible alternatives for obtaining the needed hemodynamic data that signals disease progression, treatment effectiveness, quality of live and prognoses of such kind of patients. Chronic heart failure represents one of the chronic disorders whose management might be more improved with the use of impedance cardiography and at the same time assessment of the circulation system on central, peripheral and microcirculatory levels. Data of the impedance rheoplethysmography and skin galvanic reaction are serving as starting indicators. The new studies are necessary to assess the role of this method in early detection and prevention of CHF. The given project introduces new capabilities in management of CHF and gives new possibilities to study the state of blood circulation system and it’s hemodynamic response to increased loads, evaluate latent disorders and optimize the treatment of patients with CHF, using computer based visual-differential impedansometry of the heart and vessels.
The project will be fulfilled with: In Re Center, National Center of Therapy of Georgia, and Georgian Society of Cardiology of the Cardiologists of Georgia.
The authors obtain 25-year experience in the study of medical and biological problems, the technology of biotechnical systems (BTS) synthesis in medicine and 18 automatic diagnostic systems, implemented in great number of research and clinical laboratories of the former USSR. The writers of the design have 25-year's expertise of a solution of biomedical problems. The last decade new techniques for non-invasive complex evaluation of the functional state of cardiovascular system and blood circulation were elaborated.
Within the framework of the present project we proposed the adaptation of new non-invasive technique for management of CHF, preparation of model devices for work with patients and clinical trials with new technologies. The development of algorithms and requirements for programming, development of software and mathematical rationale for unification of data processing in diagnostic devise is supposed also.
The involvement in the project of the scientists and specialists, early specialized on military subjects, will permit to change the orientation of their activities. It will enhance elaboration by using worked out BTS synthesis techniques, systemic and analyses data already obtained and being obtained, available methods of informatics and math-statistics, as well as by using their experience in creation of special data base of skills important in achieving the objectives of the project.
The International Science and Technology Center (ISTC) is an intergovernmental organization connecting scientists from Kazakhstan, Armenia, Tajikistan, Kyrgyzstan, and Georgia with their peers and research organizations in the EU, Japan, Republic of Korea, Norway and the United States.
ISTC facilitates international science projects and assists the global scientific and business community to source and engage with CIS and Georgian institutes that develop or possess an excellence of scientific know-how.