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M E D I C A L T E C H N O L O G Y & R E S E A R C H
arteries; and (c) pick up cardiac contraction abnormalities via
measurements on the chest.
LDV for measuring aortic and local PWV
LDV has been proposed as a new non-invasive method to
measure the aPWV as well as the local PWV of the common
carotid arteries (CCA).
UGent has successfully demonstrated
that aPWV can be measured correctly with LDV (Fig. 1). This
method greatly simplifies the procedures for measurement of
aPWV; however, the proposed LDV set-up for these measurements
is still bulky and expensive, which prevents this technique from
being widely used.
LDV for detection of stenosis-induced vibrations
The concept that flow through an arterial stenosis becomes
turbulent downstream and induces subsequent mechanical
vibrations is not new and has been studied since the 1970s.
The turbulent flow also induces low amplitude, acoustic shear
waves through the soft tissue in the thorax which then appear at
the chest wall. It has been demonstrated in a series of
ups that these shear waves are effectively detected using
accelerometers attached to the phantoms.
LDV for detection of cardiac contraction abnormalities
LDV can assess cardiac contraction in heart failure patients where
the correlation between electrical and mechanical dysfunction is
still a challenge.
In fact, it has been shown that LDV is
comparable to the gold standard assessment of cardiac
All the classical signs of heart failure obtained by
auscultation (gallop sounds, increased B1, mitral valve
regurgitation, B2 duplication, etc.) can be detected with much
more sensitivity and, in addition, can be quantified.
Europe is at the forefront in the field of integrated photonics. Imec
has developed over the last decade an impressive integrated
silicon photonics technology platform, with successful R&D
results having been achieved. In fact, it is capable of investigating,
developing, prototyping and manufacturing low volumes of silicon
chips and, together with Tyndall (University of Cork), delivering
packaged silicon photonics chips.
Medtronic, a leader in medical devices, has identified the unique
opportunity of bringing SIOS, a commercial supplier of homodyne
laser interferometers, together with Imec, Tyndall, UGent and
QMUL to make, for the very first time, a mobile, low cost, point of
care screening LDV for CVD.
The technology will be validated
by two academic
hospitals, Hôpital Européen Georges-Pompidou (HEGP) and
Maastricht University Hospital (UM), for the three envisioned
applications. The concept will be validated in a clinical context as
a proof of concept study to assess usability and the preliminary
level of effectiveness (Fig. 2).
The technology development will be driven and validated by end
users renowned for their expertise in diagnosis of CVD and more,
in particular on the base of PWV determination, screening of
vascular lesions, and screening of cardiac function.
Ultimately, the diagnosis of cardiac disease and dysfunction has
to be confirmed in specialised cardiological centres by advanced
ECG analysis, cardiac ultrasound, exercise testing, blood tests and
specific biomarkers or other imaging tests (MRI, nuclear imaging);
the novel device is seen as a screening tool, not a diagnosis tool.
The objective of CARDIS (Early stage CARdio Vascular Disease
Detection with Integrated Silicon Photonics) is to investigate and
demonstrate the concept of a mobile, low cost device based on
a silicon photonics integrated LDV and validate the concept for
the screening of arterial stiffness, detection of stenosis and
Investigate, design and fabricate the optical subsystems and
components: silicon photonics chip with integrated Ge-detectors,
micro-optics, micro-optical laser bench, optical package;
Integrate the subsystems and build a multi-array laser
Develop a process flow scalable to high volumes for all
subsystems and their integration steps;
Investigate and develop the biomechanical model to translate
optical signals related to skin-level vibrations into underlying
CVD physiological events; and
Validate the system in a clinical setting. Photonics integration is
needed to enable a device that is mobile (small size, small
weight and robust (no moving parts)) and low cost (high volume
scalable process flow) and allows fast screening (laser array).
Fig. 1 Laser Doppler vibrometry preliminary set-up