Abstract
Current remote monitoring devices for heart failure have been shown to reduce hospitalizations but are invasive and costly; accurate non-invasive options remain limited. The EuleriAn Video Magnification ApPLications In Heart Failure StudY (AMPLIFY) pilot aimed to evaluate the accuracy of a novel noninvasive method that uses Eulerian video magnification. Video recordings were performed on the neck veins of 50 patients who were scheduled for right heart catheterization at the Palo Alto VA Medical Center. The recorded jugular venous pulsations were then enhanced by applying Eulerian phase-based motion magnification. Assessment of jugular venous pressure was compared across three categories: (1) physicians who performed bedside exams, (2) physicians who reviewed both the amplified and unamplified videos, and (3) direct invasive measurement of right atrial pressure from right heart catheterization. Motion magnification reduced inaccuracy of the clinician assessment of central venous pressure compared to the gold standard of right heart catheterization (mean discrepancy of −0.80 cm H2O; 95% CI −2.189 to 0.612, p = 0.27) when compared to both unamplified video (−1.84 cm H2O; 95% CI −3.22 to −0.46, p = 0.0096) and the bedside exam (−2.90 cm H2O; 95% CI −4.33 to 1.40, p = 0.0002). Major categorical disagreements with right heart catheterization were significantly reduced with motion magnification (12%) when compared to unamplified video (25%) or the bedside exam (27%). This novel method of assessing jugular venous pressure improves the accuracy of the clinical exam and may enable accurate remote monitoring of heart failure patients with minimal patient risk.
Highlights
Heart failure is a tremendously morbid, deadly, and costly disease that affects 6.5 million Americans today.[1]
While physicians have traditionally relied on the bedside exam of the jugular venous pressure (JVP) to assess volume status, this can be impractical as a primary method for monitoring outpatients
We describe the application of Eulerian video magnification to the jugular venous pulse examination and demonstrate its potential as a novel method of noninvasive monitoring of right-sided filling pressures
Summary
Heart failure is a tremendously morbid, deadly, and costly disease that affects 6.5 million Americans today.[1] It is implicated in one in nine deaths in the United States and at least 20% of all hospitalizations among persons older than 65.1 It costs the United States $30.7 billion annually, a figure forecasted to increase to $70 billion by 2030.2. Much of this economic burden is generated by hospitalizations for heart failure, which represent up to 80% of direct costs, making heart failure readmissions a key target for cost reduction.[2] Preventing readmissions requires early provider intervention in the ambulatory setting, but the ideal timing and methods to achieve such interventions remain elusive. We describe the application of Eulerian video magnification to the jugular venous pulse examination and demonstrate its potential as a novel method of noninvasive monitoring of right-sided filling pressures
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