Non-invasive Vocal Biomarker is Associated with Pulmonary Hypertension

Emerging data suggest that non-invasive voice signal analysis is associated with coronary artery disease and with adverse outcome among heart failure patients. The current study evaluated the association of voice signal analysis with invasive hemodynamics of pulmonary hypertension.

Methods: Study population included patients referred for right heart study between 01/2017 and 12/2018 in Mayo Clinic catheterization laboratory, Rochester MN. All subjects had their voice signal recorded to their smartphone three times prior to the right heart study. A prespecified vocal biomarker was calculated based on all recordings. Voice analysis was blinded with respect to patients’ hemodynamic and demographic data. Patients were divided to three groups based on their mean arterial pulmonary (PA) pressure: high, intermediate and low (cutoff points of 35 and 26 mmHg).

Results: Study population included 91 patients with a mean age of 62±15 years and 42 (46%) men. Common diagnoses following the right heart study were pulmonary hypertension, heart failure and normal study in 35 (39%), 18 (20%) and 14 (15%) patients respectively. Patients with high PA pressures had significantly higher values of the vocal biomarker (0.74±.085 vs. 0.43±.086; p=.007) compared with patients with intermediate or low PA pressure. Similarly, lowest pulmonary vascular resistance (PVR<=1.7 WU) group had a significantly lower biomarker values compared with the rest of the study cohort (0.27±0.88 vs. 0.63±0.83, p=.006). Binary logistic regression with repeated measures and adjustment for age and gender showed that each standard deviation increase in the biomarker was associated with a significant 49% increased likelihood of high PA pressure (95% CI 1.07-2.08, p=.019).

Conclusion: This study suggests a potential relationship between non-invasive vocal biomarker and PA pressures measured during right heart study. The results may have clinical implications for telemedicine – when clinical health care is provided at a distance.