Heart failure patients live with a particular kind of uncertainty. Between appointments, there's often no way to know whether things are stable or quietly getting worse – until a crisis sends them to the ER.
Sean Matsuoka, CEO & Co-founder of General Prognostics (GPx), started the company in 2020 to close that gap. StartUp Health community member Matsuoka and his co-founders – one with a background at Medtronic, another in in vitro diagnostics – set out to answer a specific question: could an off-the-shelf smartwatch tell doctors when a heart failure patient needed help, before they ended up in the hospital?
"Essentially, patients are in this black box," Matsuoka said. "They don't know how they're doing. The doctors don't even know how they're doing."
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Turning wearable data into a language doctors already trust
GPx's approach doesn't ask doctors to trust a new, unproven score. Instead, the company's algorithm correlates data from consumer wearables – heart rate, heart rate variability, activity, and sleep – with NT-proBNP, a blood biomarker already used as a clinical gold standard for detecting worsening heart failure.
In a clinical study of more than 300 patients, participants wore off-the-shelf smartwatches and periodically completed blood draws, allowing the GPx team to train their algorithm against real biomarker data rather than relying on noisy wearable signals alone. The result, Matsuoka said, is a system that gives doctors roughly two weeks of lead time to intervene before a patient's condition worsens enough to require hospitalization.
"We are a CGM for heart failure, but non-invasive, just using a wearable device," he said.
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A personal mission, built for scale
For Matsuoka, the work is personal. He lost his grandmother to heart failure, and watched her live with the same uncertainty GPx is now trying to eliminate for others.
"Just having this smartwatch on her wrist gives her comfort, gives her transparency in how she's faring," he said of the patients GPx aims to serve.
The company is designed to scale well beyond the reach of implantable monitoring devices that can cost tens of thousands of dollars. By building on consumer-grade, device-agnostic hardware and existing remote patient monitoring reimbursement codes, GPx is positioning its technology to reach patients broadly, not just those with access to specialized cardiac care.
GPx is preparing for FDA clearance, with an anticipated market launch in late 2027 or early 2028.
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