Subdermal, implantable monitoring platform for heart attack and heart failure

Project Summary. Heart attacks occur approximately every 40 seconds in the U.S., often without clear symptoms, leaving many individuals unaware of their condition until serious complications arise. Notably, one in five heart attacks is silent and can only be diagnosed through in-clinic assessments using both electrocardiograms (ECG) and cardiac biomarkers, specifically cardiac troponin I (cTnI) and natriuretic peptide (NT-proBNP). When left untreated, a heart attack can lead to heart failure—a chronic, debilitating condition that increases the risk of recurrent heart attacks. Therefore, timely alerts regarding individual heart attack occurrences are essential for effective clinical intervention. While recent advancements in wearable technology facilitate continuous ECG monitoring, existing biochemical sensors are constrained by single- use measurements due to the irreversible nature of their biorecognition mechanisms. These single-use sensors provide only a snapshot of a patient’s biochemical state, limiting the ability to track the dynamics of biomarker levels that are critical for timely intervention in conditions like heart attacks and heart failure. This study aims to develop a real-time, continuous monitoring platform to track cTnI and NT-proBNP levels alongside ECG readings, with the potential to detect heart attacks before the onset of symptoms and to monitor the progression of heart failure. Aim 1 focuses on developing a cTnI and NT-proBNP monitoring module that leverages reversible aptamer switch engineering. Aim 2 involves constructing a multimodal real- time biosensing platform that will integrate a 3D-printed, flexible subdermal biochemical sensor with an external wearable device for ECG recording. Aim 3 will then focus on testing and validating this subdermal biochemical-electrophysiological monitoring platform in a heart failure rat model. This platform has transformative translational potential for individuals with a history of heart attacks or heart failure, enabling personalized cardiac care and proactive management of recurrent episodes. Additionally, this platform can be adapted to monitor a wide range of biomarkers beyond cardiac indicators by leveraging similar aptamer or molecular switch mechanisms. Expanding this technology could restructure diagnostics across multiple diseases, enabling a truly personalized system that accounts for individual variation rather than pooled averages, thereby enriching our understanding of disease processes and facilitating earlier detection and intervention.