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Feasibility Study of a New Peripheral Oedema Monitor for Heart Failure

Completed
Conditions
Heart Failure, Diastolic
Decompensated Heartfailure
Edema Brain
Interventions
Device: Heartfelt-1
Device: Weighing scales
Other: Medical grading of oedema
Other: Baseline assessements
Device: Water displacement method
Device: Callipers measurements
Device: Measuring tape
Registration Number
NCT02993601
Lead Sponsor
Heartfelt Technologies
Brief Summary

The study aims at assessing the usefulness of the Heartfelt1 device in patients suffering from heart failure, who have peripheral oedema. The device is non-contact and does not requires patient compliance to work. It gives an output reading of the patient's lower leg volume.

During the study, this measurement will be compared to clinical standard and gold standard measurements as well as clinical grading of peripheral oedema.

Detailed Description

The Heartfelt-1 device is a CE (Conformité Européenne = European Conformity) mark medical device used to measure biometric parameters of the foot and lower leg. The study aims at assessing the usefulness in patients suffering from heart failure, who have peripheral oedema. Models used for the measurements of foot and lower legs have not yet been validated for this group of patients, who are likely to have feet with abnormal surface contours and appearance secondary to oedema. Peripheral oedema can be a leading indicator of heart failure de-compensation which can lead to hospitalisation of patients, and therefore the device could be a useful clinical tool to monitor patients in their home. The Heartfelt-1 device has the ability to recognise the patient's feet (amongst an average size household setting), and trigger automatically the measurements when the feet are naked (for example as the patient goes in and out of bed). This makes the device an obvious choice for patients with compliance issues with current methods of monitoring (e.g. daily use of weighing scales) and treatment (e.g. diuretics) if it could be validated in this patient group.

The study has two general aims:

The first is to collect a time-series of data on inpatients with peripheral oedema caused by heart failure, as they receive intravenous or oral diuretic treatment to remove excess fluid and achieve optimal body weight and fluid balance. This data will be used both to determine the attainable resolution of foot biometric measurements on a patient as their fluid status changes, and also to further develop the algorithms used in the device and make them usable on a wide range of feet/lower legs which have been deformed by oedema. The data required for this study are images taken using the Heartfelt-1 device, as well as validation measurements such as the figure of eight using a medical grade tape measure, callipers, or the water displacement method using a volumetric gauge, at multiple time-points whilst the peripheral oedema reduces.

The second, on a second group of stable ambulatory (Heart Failure) HF patients with variable levels of oedema, is to evaluate the performance of the Heartfelt-1 device in determining foot biometric parameters one a wide range of patients at a single point in time. Patients with stable chronic heart failure will have their foot/lower legs measured by the Heartfelt-1 device, as well as standard medical measurement (figure of eight using a medical grade tape measure, callipers) and gold standard measurement (water displacement method using a gauge), as well as the patient's weight and a clinical grading of oedema. These will be compared and an estimate of the accuracy of the Heartfelt-1 device over this wider patient group can be extrapolated.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
70
Inclusion Criteria
  • Inpatients with admission for de-compensated heart failure requiring increase or initiation of diuretic therapy for fluid congestion.
  • Patients attending cardiology outpatients at the Royal Brompton hospital with a diagnosis of heart failure and fluid retention.
  • Cardiology patient without fluid retention (cardiology controls) Non-Cardiology patient without fluid retention (controls)
Exclusion Criteria
  • Patients unable to provide informed consent.
  • Unstable arrhythmias in previous 48 hours
  • Systolic BP<90mmHg or need for inotropic support
  • Ulceration on lower limbs (below shin) - excluded from water displacement but could have image recording and calipers
  • Inability to transfer from bed to chair
  • Patients with broken skin or cellulitis will not have their foot volume measured using the water displacement equipment to reduce the risk of infection for the patient and other participants.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
20 outpatients with peripheral oedemaWeighing scales20 outpatients with clinically detectable peripheral oedema for 1 set of measurements.
20 outpatients with peripheral oedemaBaseline assessements20 outpatients with clinically detectable peripheral oedema for 1 set of measurements.
20 outpatients with peripheral oedemaMedical grading of oedema20 outpatients with clinically detectable peripheral oedema for 1 set of measurements.
20 cardiology controlsBaseline assessements20 outpatients with heart failure without clinically detectable peripheral oedema (control group) for 1 set of measurements.
10 in-patients peripheral oedemaHeartfelt-110 in patients hospitalised as a result of heart failure and fluid congestion with peripheral oedema, those patients will have several sets of measurements taken over time to measure the reduction of peripheral oedema which is likely to show common features with the formation of peripheral oedema.
10 in-patients peripheral oedemaCallipers measurements10 in patients hospitalised as a result of heart failure and fluid congestion with peripheral oedema, those patients will have several sets of measurements taken over time to measure the reduction of peripheral oedema which is likely to show common features with the formation of peripheral oedema.
20 outpatients with peripheral oedemaHeartfelt-120 outpatients with clinically detectable peripheral oedema for 1 set of measurements.
20 outpatients with peripheral oedemaMeasuring tape20 outpatients with clinically detectable peripheral oedema for 1 set of measurements.
20 cardiology controlsWeighing scales20 outpatients with heart failure without clinically detectable peripheral oedema (control group) for 1 set of measurements.
20 cardiology controlsMeasuring tape20 outpatients with heart failure without clinically detectable peripheral oedema (control group) for 1 set of measurements.
20 outpatients with peripheral oedemaWater displacement method20 outpatients with clinically detectable peripheral oedema for 1 set of measurements.
20 outpatients with peripheral oedemaCallipers measurements20 outpatients with clinically detectable peripheral oedema for 1 set of measurements.
20 cardiology controlsMedical grading of oedema20 outpatients with heart failure without clinically detectable peripheral oedema (control group) for 1 set of measurements.
10 in-patients peripheral oedemaMedical grading of oedema10 in patients hospitalised as a result of heart failure and fluid congestion with peripheral oedema, those patients will have several sets of measurements taken over time to measure the reduction of peripheral oedema which is likely to show common features with the formation of peripheral oedema.
20 cardiology controlsHeartfelt-120 outpatients with heart failure without clinically detectable peripheral oedema (control group) for 1 set of measurements.
20 cardiology controlsWater displacement method20 outpatients with heart failure without clinically detectable peripheral oedema (control group) for 1 set of measurements.
20 cardiology controlsCallipers measurements20 outpatients with heart failure without clinically detectable peripheral oedema (control group) for 1 set of measurements.
10 in-patients peripheral oedemaMeasuring tape10 in patients hospitalised as a result of heart failure and fluid congestion with peripheral oedema, those patients will have several sets of measurements taken over time to measure the reduction of peripheral oedema which is likely to show common features with the formation of peripheral oedema.
30 control without cardiac conditionsHeartfelt-1less than 30 normal controls (healthy volunteers and patients without heart failure) in the age group 55 and above who agree to have images taken using the Heartfelt-1 device (not the whole set of measurements).
10 in-patients peripheral oedemaWeighing scales10 in patients hospitalised as a result of heart failure and fluid congestion with peripheral oedema, those patients will have several sets of measurements taken over time to measure the reduction of peripheral oedema which is likely to show common features with the formation of peripheral oedema.
10 in-patients peripheral oedemaBaseline assessements10 in patients hospitalised as a result of heart failure and fluid congestion with peripheral oedema, those patients will have several sets of measurements taken over time to measure the reduction of peripheral oedema which is likely to show common features with the formation of peripheral oedema.
10 in-patients peripheral oedemaWater displacement method10 in patients hospitalised as a result of heart failure and fluid congestion with peripheral oedema, those patients will have several sets of measurements taken over time to measure the reduction of peripheral oedema which is likely to show common features with the formation of peripheral oedema.
Primary Outcome Measures
NameTimeMethod
Volume as measured by the Heartfelt-1 deviceWithin 3 months after patient recruitment or before the end of the study (whichever is soonest).
Secondary Outcome Measures
NameTimeMethod
WeightWithin 3 months after patient recruitment or before the end of the study (whichever is soonest).

Patient weight on the day

Circumference and "figure of eight"Within 3 months after patient recruitment or before the end of the study (whichever is soonest).

Lower leg / foot circumference and "figure of eight" measurement

Medical grading of oedemaWithin 3 months after patient recruitment or before the end of the study (whichever is soonest).

Medical grading of peripheral oedema on a scale 1-5

Distance measurementsWithin 3 months after patient recruitment or before the end of the study (whichever is soonest).

Distance measurements on the foot / lower leg of the patient

Volume of the lower leg/footWithin 3 months after patient recruitment or before the end of the study (whichever is soonest).

As measured using the water displacement method.

Trial Locations

Locations (1)

Royal Brompton Hospital

🇬🇧

London, United Kingdom

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