Why invest in a diagnosis

Missing and skeptics. “About these technologies, many conversations, says Steven Nissen, head of cardiology clinic at the Cleveland Clinic. – Someone takes an idea that looks attractive, but if you dig, the scientific basis is not solid”. The usefulness of technology depends on the answer to a deeper question: how effective are stents for the treatment of heart disease and do I need to know a clogged artery or not?

The assessment is based on a Grand idea: a non-invasive test, which provides a glimpse into the coronary artery of the patient, to find out how they are clogged. Now for this kind of analysis pass the catheter from the perineum to the heart and measure blood flow. This is a bit risky procedure is called measurement of fractional flow reserve (CDF) and is performed millions of times a year around the world to determine whether the patient has a stent, bursting clogged artery. In HeartFlow claim that using their program with a deep learning algorithm, it is possible to obtain similar measurements for a snapshot of the CT volumetric image of a heart obtained using x-rays that is less risky. State insurance Medicare covers HeartFlow $1450 for the analysis.

“This will be the most effective diagnosis of cardiovascular diseases, and it is safer than any other procedure in this area, says bill Weldon, Chairman of the Board of Directors of HeartFlow and former head of Johnson & Johnson. In combination, these two factors – a winning combination”. He believes that this test will be carried out regularly.

Co-founder HeartFlow Charles Taylor in the 1990s, studied in graduate school, as the wind flows around the wings of the fighters. Similarly, is it possible to use mathematics to explain how blood flows through the heart? He made friends with Christopher Surinam, head of the Department of vascular surgery at the Medical school of Stanford University, received the degree for his work in cardiology, and he became a Professor at Stanford. In 2007 together they founded HeartFlow.

Taylor, HeartFlow responsible for technology, conducted a study on early versions of our software on the dozen patients in Latvia and received $2 million in venture investment. Stevens decided to become a surgeon after his childhood pierced forks, the toe, and 20 years ago ceased to operate on the heart and left in a startup. He joined Taylor in 2010.

In the course held in 2014 research program HeartFlow CT scans were analyzed 254 patients. The results coincided with the testimony of FRK in 84% of cases of obstruction in 86% of cases detection of free blood flow. In the same year, the Office of food and drug administration gave approval for the use of the HeartFlow program in medicine to identify symptoms of coronary artery disease.

Test HeartFlow is mainly used in doubtful cases. The KT 60-year-old medical investor Hank Pleyn showed the hardened plaque in his coronary arteries. However, a stress test (walking on a treadmill with electrodes on the chest) has not confirmed the existence of problems. When KT passed through the program HeartFlow, was discovered two partial blockage. And his doctor decided to install two stents. “Very scary to know that you had heart disease, despite the fact that it was members of your family, says pleyn. – Good that you can return to a normal life.”

The question of whether, in some cases, the stents are worth the money and risk. They save lives for heart attack and ease chest pain. But conducted 10 years ago, the study of 2287 patients, and the recent investigations of fraud are in doubt that stents generally work better than medication. So HeartFlow prevent unnecessary procedures or leads to them?

In HeartFlow say that every analysis cost $1450 saves $4000. “But whether patients live longer if they have less heart attacks when using this approach compared to usual?” – asks Venkatesh Murthy, cardiologist at the University of Michigan. Do patients need, in principle, to check heart blood flow?

There are technical doubts. HeartFlow expects the flow of blood by analyzing the shape of the vessel, so it is possible to estimate the velocity of the river form its shores. “Trying to measure FRC by the image of CT is like running a marathon on one leg,” says Darrel Francis, Professor of cardiology from the British National Institute for heart and lung. According to the publication in the journal JAMA Cardiology, analyses of blood flow in the CT images (which do not use only one program HeartFlow) is not so accurate in the study of difficult patients. In HeartFlow find the flaws in the study, formed the basis of this publication.

The technology has many supporters, among them cardiologist Robert D. Safyan from the Beaumont Health hospitals in California. “I used to be one of the most ardent skeptics, but now I think this is amazing technology,” he says. Over the past three years he used HeartFlow for 2000 patients. New data, released August 25 at the annual meeting of the European society of cardiology, show that the use of HeartFlow makes doctors change the approach to treatment of patients, but this is unlikely to put an end to the dispute. “In the end the top will take the data,” – said the head of the HeartFlow John Stevens.

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