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. 2025 May;4(5):101753.
doi: 10.1016/j.jacadv.2025.101753. Epub 2025 Apr 28.

Noninvasive Hemodynamic Assessment by a Sensor Patch: The PATCHWRK (PortAble TeCHnology for Wireless caRdiomyopathy tracKing) Study

Zak Loring  1 , Nicholas B Bolus  2 , F Brennan Torstrick  2 , Danielle Wilson  3 , Melissa Lefevre  3 , Brett D Atwater  4 , Anita Kelsey  3 , Jonathan P Piccini  5
Affiliations

Noninvasive Hemodynamic Assessment by a Sensor Patch: The PATCHWRK (PortAble TeCHnology for Wireless caRdiomyopathy tracKing) Study

Zak Loring et al. JACC Adv. 2025 May.

Abstract

Background: Echocardiographic timing intervals provide prognostic information in patients with preclinical cardiac dysfunction. Reduced diastolic filling time (DFT) identifies left bundle branch block patients at risk for cardiomyopathy. The need for specialized equipment limits the utility of echocardiography (echo) for longitudinal assessment.

Objectives: The purpose of this study was to evaluate a multimodal sensor patch's (SANSA) assessment of DFT, pre-ejection period (PEP), and left ventricular ejection time (LVET).

Methods: Fifty patients undergoing echo were prospectively enrolled and had simultaneous SANSA patch recording and echo. Timing intervals were analyzed using continuous wave, pulsed wave, and tissue Doppler imaging. SANSA electrocardiogram, seismocardiogram, and phonocardiogram data were independently analyzed to identify valve openings/closures for DFT, PEP, and LVET estimation. Agreement between echo and SANSA estimates was assessed using intraclass correlation coefficients (ICC) and compared with agreement between echo views.

Results: Forty-six of the 50 patients (92%) had analyzable data. The mean ejection fraction was 53% ± 8%; 13 patients (26%) had left bundle branch block. Echo-estimated mean DFT, PEP, and LVET were 416 ± 139 milliseconds (ms), 108 ± 32 ms, and 300 ± 36 ms, respectively. SANSA-estimated DFT, PEP, and LVET were 431 ± 135 ms, 91 ± 35 ms, and 285 ± 43 ms, respectively. The ICC for SANSA vs echo was 0.92 for DFT, 0.74 for PEP, and 0.76 for LVET. The ICC for tissue Doppler imaging vs pulsed wave estimates within the same patients was 0.93 for DFT, 0.83 for PEP, and 0.69 for LVET.

Conclusions: SANSA patch monitoring accurately measures key cardiac timing intervals to within the variability observed between echo views. As these intervals have prognostic value, SANSA-based longitudinal monitoring may facilitate early cardiomyopathy detection.

Keywords: diastolic function; echocardiography; left bundle branch block; patch sensor.

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Conflict of interest statement

Funding support and author disclosures This work was funded by NIH grant 1R43HL158282. Dr Loring has received grant support from Boston Scientific and the Department of Veterans Affairs and has served as a consultant for Huxley Medical Inc and Boston Scientific. Dr Piccini is supported by R01AG074185 from the National Institutes of Aging; has received grants for clinical research from Abbott, the American Heart Association, the Association for the Advancement of Medical Instrumentation, Bayer, Boston Scientific, iRhythm, and Philips; and also has served as a consultant to Abbott, Abbvie, Ablacon, Altathera, ARCA Biopharma, Bayer, Biotronik, Boston Scientific, Bristol Myers Squibb (Myokardia), Element Science, Huxley Medical Inc, Itamar Medical, LivaNova, Medtronic, Milestone, ElectroPhysiology Frontiers, ReCor, Sanofi, Philips, and Up-to-Date. Dr Atwater has received research support from Medtronic and Pfizer and has served as a consultant to Medtronic, Biosense Webster, and Cortex Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
SANSA Patch Multimodal SANSA patch capable of measuring simultaneous electrocardiogram (ECG), seismocardiogram (SCG), and phonocardiogram (PCG). HR = heart rate; HRV = heart rate variability; PPG = photoplethsymogram.
Figure 2
Figure 2
Simultaneous SANSA and Echo Assessment of Pre-Ejection Period, Left Ventricular Ejection Time, and Diastolic Filling Time Tissue Doppler imaging (TDI) of the mitral annulus (A) with simultaneous SANSA patch measurements integrating ECG, SCG, and PCG signals (B) to estimate IVCT (time 1 on TDI image), IVRT (time 4 on TDI image), PEP (time 2 on TDI image), DFT (time 5 on TDI image), and LVET (time 3 on TDI image). AC = aortic closing; AO = aortic opening; DFT = diastolic filling time; ECG = electrocardiogram; IVCT = isovolumetric contraction time; IVRT = isovolumetric relaxation time; LVET = left ventricular ejection time; MC = mitral closing; MO = mitral opening; PCG = phonocardiogram; PEP = pre-ejection period; SCG = seismocardiogram.
Figure 3
Figure 3
Correlation of SANSA and Echo Timing Intervals Bland-Altman plots and correlation plots comparing SANSA estimates of DFT, PEP, LVET, IVCT, and IVRT to mean echo values as well as between tissue Doppler imaging (TDI) and continuous wave (CW) echo views. Patients with left bundle block are marked in blue. Abbreviations as in Figure 2.
Figure 4
Figure 4
Comparison of In-Clinic and At-Home SANSA Recording In-clinic data (A, C) compared to at-home data (B, D) for 2 subjects (top and bottom rows). Abbreviations as in Figure 2.
Central Illustration
Central Illustration
Simultaneous SANSA and Echo Assessment of Timing Intervals Show Excellent Agreement SANSA patch measurements integrating ECG, SCG, and PCG signals (top) identify key cardiac timing intervals with excellent agreement to simultaneously obtained echocardiographic-based measurements (middle). The bottom panel compares agreement between SANSA assessment of DFT and the mean value by echo (left) to the agreement between DFT assessment by continuous wave Doppler (y-axis) and tissue Doppler imaging (x-axis). The agreement between SANSA and echo measurements was similar to the agreement seen between different echo views (bottom). CW = continuous wave; TDI = tissue Doppler imaging; other abbreviations as in Figure 2.
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