Multisensor Array for the Localisation of Coronary Artery Stenosis

This project is a trial of a novel device, in the form of a stick-on patch containing miniature accelerometers and microphones, designed to detect sounds produced by disturbed blood flow in stenosed coronary arteries. Initially, acoustic data will be collected from a small group of healthy volunteers to confirm proof of concept. Recordings from the patch will then be made on up to 100 patients who, having presented with chest pain to the Barts Heart Clinic, are undergoing simultaneous CTa investigations to determine the presence or absence of occlusive CAD.

The purpose of the study is to determine if the nature of the signals recorded by the patch makes it possible to distinguish those patients who have identifiable CAD, as detected by CTa (the reference method) from those in whom no occlusive lesions can be seen in the CTa images. The measurements on patients will be preceded by a trial on 20 healthy volunteers to establish base line readings and to ensure the reliability of the patch and the associated data acquisition system, in the field.

Coronary artery disease (CAD) is the leading cause of death worldwide. In Europe alone in 2014 the resulting cost of health care, and lost production was around €100 billion per year. Existing diagnostic methods apart from ECG require skilled operators and expensive equipment.

Recent advances in cCTA make it possible to detect and localise occlusive lesions with high accuracy and precision, whilst minimising the use of contrast media, albeit at the cost of some exposure to ionising radiation. Of equal or greater concern is the fact that approximately 2/3 of symptomatic patients are found, on investigation, to be occlusion-free, representing a great waste of resources and thus a loss of productivity for the healthcare system and the patients themselves, to say nothing of their distress on facing a false positive diagnosis and the risks associated with contrast injection and exposure to unnecessary ionising radiation.

The non-invasive system proposed here would be applied to symptomatic patients with stable chest pain attending a cardiac outpatient clinic with the intention of screening out the 2/3 mentioned above, resulting in large cost and time savings.