I’ve always thought of the heart a little like the engine of the body. The comparison obviously only goes so far, but there is something useful in it: an engine can appear to be running perfectly well at one moment and behave very differently when you put it under load, change the conditions around it or follow its performance over time.
The heart is far more complex, but it is also constantly responding to what is happening to us. Physical exertion, psychological stress, illness, recovery and medical treatment can all affect the way it functions. That makes the heart not only something we investigate when we suspect cardiovascular disease, but potentially one of the clearest windows we have into how the body is responding to the circumstances around it.
The challenge is that healthcare has traditionally been much better at taking sophisticated measurements at particular moments than it has been at following change between those moments.
ECGs and echocardiograms are essential parts of cardiac care and will remain so, but they are generally ordered for a particular reason and performed at a particular point in time. What interests me is what we can learn when cardiac measurement becomes simple and portable enough to repeat, not as a replacement for established diagnostics, but as another layer of information that clinicians can draw on as they follow a patient.
That shift from an occasional reading towards a longitudinal picture could change where, when and why we look at the heart.
From a snapshot to a pattern
If you measure something once, you learn what was happening at that moment. If you can measure it repeatedly under reasonably consistent conditions, you can start to understand what is normal for that individual and, importantly, whether that is changing.
This is something I keep coming back to because our health is dynamic. A person does not experience stress once, recover once or respond to treatment once. These things unfold over days, months and sometimes years, yet much of the information available to clinicians is necessarily gathered during individual appointments.
At LLA Technologies, this is the thinking behind Recordis. The platform uses seismocardiography, or SCG, to capture the micro vibrations created by the mechanical activity of the heart through a non-invasive sensor placed on the chest. A recording takes around a minute, with the resulting signals used to generate measurements relating to different parts of the cardiac cycle.
What matters most to me isn’t that we can take a recording quickly; it’s that by making the process simpler, portable and repeatable, we have the opportunity to bring cardiac monitoring into places where it has historically been difficult to provide.
Recordis has been designed so measurements can be taken in a clinic, workplace or community setting without the infrastructure required for cardiac imaging, while the clinical platform allows healthcare professionals to review results and follow changes over time. The purpose is not to replace the cardiologist or to turn every cardiac measurement into a diagnosis, but to make clinically useful information about the heart easier to gather wherever care is already happening.
Consumer wearables have done something important in making people comfortable with the idea that health can be followed over time rather than checked once a year. The clinical opportunity is different. It is about gathering measurements for a defined medical purpose, under appropriate conditions, and putting that information in the hands of professionals who can interpret it alongside everything else they know about the patient.
The same heart, very different circumstances
The potential becomes particularly interesting when you look beyond traditional cardiology settings.
One area we have spent several years studying is occupational health. Recordis has been used as part of research involving Royal Canadian Mounted Police cadets, examining cardiac function alongside the considerable physical and psychological demands associated with police training.
For me, the interesting part is not the idea of producing a single “stress score”. Human beings are far too complicated for that. It is whether we can understand how the physiology of an individual changes over time and connect that information with what we know about workload, recovery, mental health and the environment in which they are operating.
That same principle can apply in a completely different context.
In oncology, for example, we already know that certain treatments can affect the heart and that monitoring cardiac function can therefore become part of a patient’s care. We are now researching whether mechanical cardiac signals captured through SCG can provide additional information around measures such as global longitudinal strain, an established measure of how the heart muscle deforms as it contracts.
There is still clinical work to be done, but the wider opportunity is compelling: if meaningful changes can eventually be followed with a short, portable assessment, clinicians could have another way of observing what is happening between larger investigations rather than waiting for the next scheduled snapshot.
Paediatric care raises another version of the same question. Children receiving cancer treatment may require cardiac follow-up over many years, sometimes long after their original treatment has ended. Making appropriate assessments easier to repeat could have real value for patients and families, provided the evidence is established specifically for that population.
Then there is geography.
For somebody living several hours from specialist care, the difference between a measurement that requires major equipment and one that can be taken locally is not simply one of convenience. It can determine how often that person can realistically be assessed.
I think this is where portability in healthcare becomes genuinely meaningful. Sending a device into a remote community is not, by itself, a solution; there still needs to be a clinician, a pathway and a clear understanding of what happens when something changes. But when portable technology is connected to that clinical infrastructure, it creates the possibility of bringing information to the specialist rather than requiring the patient to travel every time information is needed.
Making prevention measurable
Healthcare talks a great deal about prevention, and rightly so, but prevention becomes much more useful when we can measure what is changing.
Telling someone to manage stress, become more active or improve their recovery is one thing. Understanding whether their physiology is responding over time gives both the individual and the healthcare professional something more tangible to work with.
That does not mean every fluctuation requires an intervention, and it certainly does not mean the heart can tell us everything that is happening elsewhere in the body. What it can do is provide another source of objective information, and the more practical that information becomes to collect, the more situations there are in which it can potentially contribute to care.
The same applies at a health-system level. Specialist resources are finite. Echocardiography, cardiology appointments and advanced imaging should be directed towards the patients who need them, and better information earlier in the patient journey could help clinicians make those decisions with greater confidence.
That is ultimately what interests me about repeatable cardiac measurement. The technology itself matters, but the larger opportunity is to change the relationship we have with cardiac information and cardiac care: from something we collect mainly when a problem is suspected towards something that, where clinically appropriate, can help us understand change before the next major decision has to be made.
The heart is working every second of our lives and responding constantly to what we ask of our bodies. If we can make clinical measurements simple enough to follow some of those changes over time, we may find that cardiac information has a useful role much further beyond the cardiology clinic than we once assumed.
David Loban
David Loban is CEO of LLA Technologies and developer of Recordis, a portable cardiac monitoring system that uses a chest-mounted sensor to measure the heart’s mechanical activity, allowing healthcare professionals to assess cardiac function and track changes over time.
