Why I invested in Respirix

I’m really excited to have been able to invest in Respirix. Based in San Francisco, Respirix is a healthcare company on a mission to revolutionize cardiac monitoring. Respirix is developing a novel approach using software and hardware to measure hemodynamic parameters (that currently require expensive and invasive implants) at low cost and non-invasively. The technology has wide potential, but they are initially focused on bringing a game-changing monitor for congestive heart failure (CHF) patients to market that will allow their physicians to monitor them remotely and help prevent dangerous and expensive hospitalizations.

Heart disease is something I personally care about because it’s impacted my family directly in the past: several of my grandparents and pets died from heart disease (and some specifically CHF). Now, there are many companies chasing heart failure -- it is a very big market. Every year in the United States, about one million CHF patients are hospitalized for what is called “decompensation” (fluid retention in the body and lungs); the estimated cost of these hospitalizations in the U.S. for 2010 was $39.2 billion, and that number is forecasted to reach $70 billion by 2030. Importantly, over 50% of CHF patients are readmitted to the hospital within 6 months of discharge.

Today, there is only one FDA-approved device for CHF patients to monitor their status at home. It’s an implant that costs $18,000 and gets placed permanently inside the pulmonary artery in the heart through a surgical procedure. Despite these challenges, this technology was acquired for $455 million before selling a single device when it was demonstrated that the daily measurements it provided could predict decompensation in advance and allowed physicians to have patients take medication that reduced CHF hospitalizations by 38% in a 470 patient trial.

Now, imagine that instead of having a chip placed inside your heart for life, you simply had to breathe into a sensor and get the same analysis of your condition. Sounds amazing, right? That is precisely what Respirix is doing. Respirix’s approach involves using precise analysis of breath exhalation (proprietary signal along with machine learning) to monitor changes in pressure caused by the pulmonary vasculature, which may be a more sensitive indication of pulmonary artery compliance.

So far, the Respirix team has accomplished a number of important milestones, including building over twenty of their Cardiospire devices, acquiring animal model data, starting multiple clinical trials, winning grants, and recruiting a strong team and advisors.

If successful, Respirix’s first product would make it a lot less invasive and easier for CHF patients to have their health monitored at home. I know startup risks are large and the probability of success is generally low, but Respirix has a differentiated approach and has gotten very solid results to date, and they are tackling a huge market opportunity. That being said, I like that the CEO has a lot of personal skin in the game and cares passionately about seeing the Respirix solution become reality. I’m proud to have invested alongside Synergy Ventures, Signatures Capital, Theranova, and StartX.

I’m personally excited about the company because given my family history, I recognize that there is a strong need for new technologies to treat heart disease more effectively, at lower cost, and with increased patient access.

What I love:

• Founder with lots of personal skin in the game
• Built strong scientific, engineering, and advisory team
• Multiple patents filed
• Good progress on device development and clinical trials
• Good feedback from experts

Risks:

• Difficult, long, expensive, risky process to get to FDA approval
• Full product technology value proposition still not entirely proven out
• Need to get physicians on board to promote and incorporate it into their practices