Tensiotrace is more than halving the duration of ambulatory investigation of cardiovascular patients


Welcome to Tensiotrace!

Tensiotrace Ltd was organised for development and validation of diagnostic methods and tools for cardiovascular medicine. Through close cooperation with the scientific and medical communities in Estonia we develop new cardio-vascular diagnostic tools. Our current focus is in multiparameter analysis of ECG and pulse wave signals.

Tensiotrace Ltd was founded in 2006 as a partner company for Tallinn University of Technology (TUT). The founders of the company are professors of Technomedicum of TUT. In the company their professional expertise in the field of biomedical science is combined with the business expertise of local technology investors. The company has several patents and utility models in the field of cardiovascular signal registration and analysis.

In 2006 a Enterpise Estonia (EAS) supported the activites of the company with a research grant and in 2011 we received a research grant from European Space Agency (ESA).

TT50 MULTISIGNAL HOLTER RECORDER

12-channel ECG with up to 8kHz sampling rate
Pulse wave recording and pulse arrival time (PAT) calculation
Beat to beat systolic blood pressure estimation
Respiration waveform registration
SpO2 registration
Built in accelerometer for activity monitoring
Continuous recording time up to 48 hour
Built-in rechargeable battery and flash memory
Bluetooth connection for online review of the recording

CHALLENGE

Cardiovascular diseases (CVD) are the leading global cause of death, accounting for more than 17.3 million deaths per year (31%) in 2013, a number that is expected to grow to more than 23.6 million by 2030.1 In the EU-28, in 2012 there were 1.9 million (38%)2 deaths resulting from diseases of the circulatory system, whereas in the US 801,000 people (1/3) died from heart disease, stroke and other cardiovascular diseases in 2013. At the same time, the number of in-patients with diseases of the circulatory system discharged from hospitals across the EU was 11.1 million in 2013. Those patients tend to spend a relatively lengthy period of time in hospital (around 10 days). Across the EU in 2013, in-patients with diseases of the circulatory system spent a total of 94.7 million days in hospital. Consequently, diseases of the circulatory system place a considerable burden on healthcare systems and government budgets. Direct and indirect costs of cardiovascular diseases and stroke – health expenditures and lost productivity – total more than EUR 270 billion.

As for cardiovascular health, the most important determinant of it is a person's age. In a nutshell, aging has a remarkable effect on the heart and arterial system, leading to an increase in CVD including atherosclerosis, hypertension, myocardial infarction, and stroke. By 2030, approximately 20% of the population will be aged 65 or older. In this age group, CVD will result in 40% of all deaths and rank as the leading cause. Furthermore, the cost to treat cardiovascular disease will triple in that time.

A number of factors today are indicating that there will be an expansion in ambulatory care services. As people live longer, chronic disease increases, and the frequency of patient visits increases, consequently, the ability for providers to collaborate and manage several conditions in tandem will play an ever-increasing role. Doing this efficiently will be critical to patient health and cost-effective care.

Traditionally, a patient with cardiovascular complications pays a visit to a doctor's office who measures blood pressure (BP) and records electrocardiography (ECG) data, possibly other parameters critical for cardiovascular health/diseases. Such visits provide only one-time snapshots of the patient's condition. For longer term monitoring, the current most commonly used outpatient evaluation method of all major heart diseases (coronary heart disease, arterial hypertension and consequent cardiac failure, cardiac arrhythmias, myocardial and valvular diseases) is extended ECG recording whereby a holter monitor with a conventional tape recorder or solid-state storage system is used for acquiring ECG information (typically for 24-48 hours) that can then be reviewed to check for the efficacy of antianginal and antiarrhythmic drugs, surgical and ablation treatment, and potential side effects of drugs.

Additionally, another widely used test is ambulatory arterial blood pressure (BP) monitoring, which helps obtain adequate information on the dynamics of BP over a 24-hour period, as well as draw conclusions regarding hypotensive drug treatment efficacy and side effects.

Concluding from the above, to provide a complex cardiovascular risk analysis, the patient has to go to the doctor’s for several times, plus experience the uneasiness of the many 24-hour (or longer) monitoring devices, e.g. with the cuff ending up being painful and/or causing bruises (especially for the elderly). From the doctor’s point of view, such long-term monitoring of patients means, besides the spent time factor (doctor + nurse), the possession of several sets of diagnostic systems (circa EUR 60,000 per set)4 which all need regular care and maintenance. Thereaſter the obtained data has to be correlated and analysed carefully to get any meaningful results.

SOLUTION

Tensiotrace provides a unique-in-the-world 3-in-1 solution for beat-to-beat monitoring of significant cardiovascular parameters (ECG, BP, pulse wave). Tensiotrace is aiming at more than halving the duration of ambulatory investigation of cardiovascular patients by integrating 24-hour recording of ECG and blood pressure (BP) into a single cuff-less device with unprecedented patient comfort and finely correlated data points. The cost advantage of the device over the current state-of-the-art is circa 4-fold.

First and foremost, the diagnostic & prognostic device provides precise and accurate (beat-to-beat), complex but well-correlated datasets (simultaneously about electrical and haemodynamic cardiovascular properties) as crucial information on the relationship between systolic BP (SysBP), ECG anomalies and cardiovascular diseases. The device is targeted at both patients with vascular diseases and individuals identified at high multi-factorial risk, to help them predict and prevent further aggravation of the condition.

The innovation would bring benefits to both medical service providers (cardiologists and other physicians) by bringing down investment costs, and to the end users by increasing patient comfort (much less cumbersome and painless) and, ultimately, wellbeing by early multi-track detection of possible (complex) health anomalies.

PUBLICATIONS

Biomedical Research International, 2015, 1−7

Viigimäe, Moonika; Karai, Deniss; Pirn, Peeter; Pilt, Kristjan; Meigas, Kalju; Kaik, Jüri (2015). QT Interval Variability Index and QT Interval Duration in Different Sleep Stages: Analysis of Polysomnographic Recordings in Nonapneic Male Patients

Proceedings of the Estonian Academy of Sciences, 63 (3), 221−226

Pilt, Kristjan; Meigas, Kalju; Kööts, Kristina; Viigimaa, Margus (2014). Photoplethysmographic signal rising front analysis for the discrimination of subjects with increased arterial ageing.

Physiological Measurement, 35, 2027−2036

Pilt, Kristjan; Meigas, Kalju; Ferenets, Rain; Temitski, Kristina; Viigima, Margus (2014). Photoplethysmographic signal waveform index for detection of increased arterial stiffness.

The Scientific World Journal, 2013, 9 pp

Pilt, Kristjan; Ferenets, Rain; Meigas, Kalju; Lindberg, Lars-Göran; Temitski, Kristina; Viigimaa, Margus (2013). New Photoplethysmographic Signal Analysis Algorithm for Arterial Stiffness Estimation.

Estonian Journal of Engineering, 16 (1), 78−94

Pilt, Kristjan; Meigas, Kalju; Ferenets, Rain; Kaik, Jüri (2010). Photoplethysmographic Signal Processing Using Electrocardiogram Reference Adaptive Sum Comb Filter for Pulse Delay Measurement.

Scandinavian Cardiovascular Journal, 45, 33 – 40

Pshenichnikov, I.; Shipilova, T.; Karai, D.; Riipulk, J.; Veski, K.; Pilt, K.; Kaik, J. (2011). Association between ventricular repolarization and main cardiovascular risk factors.

Estonian Journal of Engineering, 16 (1), 107 – 120

Veski, Kristi; Karai, Deniss; Pilt, Kristjan; Meigas, Kalju; Kaik, Jüri (2010). Application of novel QT interval correction and QT/RR assessment models to ECG 24- hour recordings in cardiac patients.

Estonian Journal of Engineering, 16, 78 – 94

Pilt, Kristjan; Meigas, Kalju; Ferenets, Rain; Kaik, Jüri (2010). Photoplethysmographic Signal Processing Using Electrocardiogram Reference Adaptive Sum Comb Filter for Pulse Delay Measurement.

Seminars in Cardiovascular Medicine, 14: 2, 14 – 19

Pshenichnikov, I.; Shipilova, T.; Laane, P.; Meigas, K.; Anier, A.; Kaik, J. (2008). Prognostic value of QT interval dispersion during exercise in patients with stable angina.

Seminars in Cardiovascular Medicine, 54- 59

Shipilova, T.; Pshenichnikov, I.; Udras, A.; Anier, A.; Meigas, K.; Kaik, J. (2007). Relationship between Heart Rate, QT Dispersion and Leſt Ventricular Geometry in a Middle-aged Hypertensive Tallinn Population.

Proceedings of the Estonian Academy of Sciences. Engineering, 10(2), 123 – 136

Lass, J.; Meigas, K.; Kattai, R.; Karai, D.; Kaik, J.; Rossmann, M. (2004). Optical and electrical methods for pulse wave transit time measurement and its correlation with arterial blood pressure.

Blood Pressure, 12(1), 12 – 18

Shipilova, T.; Pshenichnikov, I.; Kaik, J.; Volozh, O.; Abina, J.; Kalev, M.; Lass, J.; Karai, D (2003). Arterial hypertension, leſt ventricular geometry and QT dispersion in a middle-aged Estonian female population.

Scandinavian Cardiovascular Journal, 37(2), 87 – 90

Pshenichnikov, I.; Shipilova, T.; Kaik, J.; Volozh, O.; Abina, J.; Lass, J.; Karai, D (2003). QT dispersion in relation to leſt ventricular geometry and hypertension in a population study.

Europace, 3(3), 221 – 228

Lass, J.; Kaik, J.; Meigas, K.; Hinrikus, H.; Blinowska, A (2001). Evaluation of the quality of rate adaptation algorithms for cardiac pacing.

THE TEAM

Moonika Viigimäe

PhD student in the Department of Health Technologies at the Tallinn University of Technology (Estonia) since 2014 – exploring ventricular repolarization electrical signals in patients with and without obstructive sleep apnea. She received a master's degree in Exercise Science from the George Washington University (Washington DC, USA) in 2004. She has worked as a physician at the Estonian Institute of Cardiology (1994–1997), as a director of the Estonian Antidoping Center (2004-2006), as a chief specialist at the Ministry of Social Affairs (2006-2008), and as a head of the Health Promotion Chair at the Tallinn Health Care College (2009-2017). In 2017, she started the gradual medical training in the field of rehabilitation at the University of Tartu (Estonia). She is a member of the European Heart Rhythm Association (EHRA), the Estonian Sleep Medicine Association, and the Health Promotion Union of Estonia.

+ Jüri Kaik + (18.05.1953 – 23.06.2017)

Professor of Technomedicum of Tallinn University of Technology. He has been the coordinator of 10 national scientific programmes and a coordinator and co-coordinator of several international projects, including WHO/CINDI sub-projects, EU 5-th framework projects, etc. He is a member of several national and international cardiology, electrophysiology and biomedical engineering scientific societies, a Member and Fellow of the European Society of Cardiology, and a Member of the Board of the Estonian Association of Sleep Medicine. He has published about 160 scientific papers, is an inventor of 8 inventions: 4 Soviet Union Author’s Certificates, one French patent, 2 EU patents and 3 Estonian patents.

Mart Rein Rosmann

Executive Director of Private Limited Company Emros OÜ – Graduate Engineer, PhD. From 1990 - Executive Director of Private Limited Company Emros OÜ; 1986 – 1990 Manager of Tallinn Medical Diagnostics Laboratory at Võru Production Association of gas analyzers; 1968-1985 Director of Developmental-and-research Division in Tallinn Industrial Machinery Production Association; Professional qualification: 1967 – Graduate Engineer, Tallinn University of Technology, 1976 – Doctor of Technical Sciences, Leningrad Institute of Electrical Engineering. Main activities in science: measurement of blood flow in blood-vessels, gas exchange in respiration, respiratory analyses, blood pressure measurement – more than 40 scientific publications including patents and utility models. Main activities in engineering: development of blood flow meters, gas analyzers, spiro meters, blood pressure meters.

Kalju Meigas

Professor of Biomedical Engineering, Head of Chair, Director of Technomedicum of Tallinn University of Technology, and a steering board member of the Estonian Centre of Excellence for Integrated Electronic Systems and Biomedical Engineering CEBE. He received his PhD in Electrical Engineering from Tallinn University of Technology in 1997 and his main research interests include Biomedical Engineering and Laser Applications in Medical Diagnostics. He is a board member of Division for Health Care Technology Assessment of the International Federation for Medical and Biological Engineering and belongs to the Editorial Board of Measurement Science Review and Bioelectromagnetics journals. He is an Estonian Chartered Engineer and a member of many associations of biomedical engineering and medical physics. He has published about 120 scientific papers, is a co-author of 3 books and an inventor of 8 inventions: 2 Soviet Union Author’s Certificates, one French patent, 2 EU patents and 3 Estonian patents.

Jaanus Lass

Senior researcher at the Department of Biomedical Engineering of Technomedicum of TUT since 2002. He has a PhD from Tallinn University of Technology (2002). He is a member of the Professional Council of Engineers in Estonia and he has been a president of Estonian Society of Biomedical Engineering and Medical Physics since 2001. His special fields of interest include Signal processing (Signal processing in Biomedical Engineering) and Medical technology (EEG and ECG signal registration and processing; microwave interaction with human nervous system; analysis of non-invasive cardiovascular parameters). Dr. Lass has over 135 publications, including 18 ISI research papers. Mr. Lass is also a board member of AB Medical Service OÜ.

Kristjan Pilt

Researcher at the Department of Biomedical Engineering of TUT since 2009 Got his PhD from the Technomedicum of TUT in 2014. The thesis “Optical methods in cardiovascular diagnostics” was supervised by Kalju Meigas and Margus Viigimaa. He defended his MSc in 2008 in the Faculty of Information Technology of TUT (title of the master thesis: “The Recording and Processing of Photoplethysmographic Signal“). His fields of research include Medical Engineering (Optical methods in cardiovascular diagnostics) and Telecommunications (Signal processing). He has 18 publications, incl. 6 ISI research papers. In 2008 he was honoured with the Estonian Association of Engineers’ title of honour –Technical Student of the Year.

Deniss Karai

Works for the Department of Biomedical Engineering at Tallinn University of Technology. He has more than 10 years of experience in physiological signal registration as well as analysis and device prototyping. His main research topics include EEG, ECG and PPG signal processing and soſtware development for biomedical engineering applications. He has published about 40 scientific papers.

Avo Tölpt

CEO of Tensiotrace. Entrepreneur and angel investor. He is also the Head of the Supervisory Board of Airest Inc. Main activities: consulting and business venture.

CONTACTS

Tensiotrace Ltd

Majaka str. 26, Tallinn, 11416, Estonia.
Reg.nr. 11050283