Voice recognition as an innovative method to identify and monitor heart failure – a review

Amy S. Fuller; Nduka C Okwose; Sarah J. Charman; Alban E. Voppel; Renae J. Stefanetti; Amy Groenewegen; Annamaria Del Franco; Maria Tafelmeier; Andrej Preveden; Aleksandra Milovancev; Duncan Edwards; Anne P. Nelissen; Fausto Barlocco; Alessandra Fornaro; Jose Luis Zamorano; Massimo Milli; Laura Sasso; Giulia Taborchi; Simone Bartolini; Serena Fatucchi; Prithwish Banerjee; Guy A. MacGowan; Oscar Fernandez; Marta Jimenez-Blanco Bravo; Lars S. Maier; Iacopo Olivotto; Frans H. Rutten; Jonathan Mant; Lazar Velicki; Petar M. Seferovic; Nenad Filipovic; Djordje G. Jakovljevic

doi:10.1007/s10741-026-10625-3

Voice recognition as an innovative method to identify and monitor heart failure – a review

Amy S. Fuller
, Nduka C Okwose
, Sarah J. Charman
, Alban E. Voppel
, Renae J. Stefanetti
, Amy Groenewegen
, Annamaria Del Franco
, Maria Tafelmeier
, Andrej Preveden
, Aleksandra Milovancev
, Duncan Edwards
, Anne P. Nelissen
, Fausto Barlocco
, Alessandra Fornaro
, Jose Luis Zamorano
, Massimo Milli
, Laura Sasso
, Giulia Taborchi
, Simone Bartolini
, Serena Fatucchi

Prithwish Banerjee, Guy A. MacGowan, Oscar Fernandez, Marta Jimenez-Blanco Bravo, Lars S. Maier, Iacopo Olivotto, Frans H. Rutten, Jonathan Mant, Lazar Velicki, Petar M. Seferovic, Nenad Filipovic, Djordje G. Jakovljevic

Centre for Discoveries in Life Sciences

University Hospitals Coventry and Warwickshire NHS Trust
Newcastle University
Newcastle upon Tyne NHS Hospitals Foundation Trust
McGill University
National Institute for Health and Care Research
University of Utrecht
University of Florence
University Medical Centre of Regensburg
University of Novi Sad
Institute of cardiovascular diseases of Vojvodina
University of Cambridge
University Hospital Ramón y Cajal
Health Institute Carlos III
Santa Maria Nuova Hospital
University of Belgrade
BIOIRC - Bioengineering Research and Development Center
University of Kragujevac

Research output: Contribution to journal › Article › peer-review

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Abstract

Screening of heart failure (HF) remains suboptimal. However, vocal biomarkers are an emerging tool to screen for HF and predict adverse outcomes. This article is a literature review of the current evidence, exploring the use of vocal biomarkers to screen for HF and predict hospitalisation and mortality. Voice may be utilised as a time-efficient method for the screening of HF, risk stratification, and monitoring of disease progression. Vocal biomarkers such as pause ratio and artificial neural networks can screen for HF accurately in a case-control setting. Other vocal markers like maximum phonation time, creak percent are useful to monitor disease progression. Vocal biomarkers appear to match current predictors of one-year mortality, HF related decompensation and hospitalisation. The integration of vocal biomarkers assessment in HF healthcare is promising across primary and secondary care settings. Key challenges including health data protection, regulatory compliance, and user acceptance must be addressed before these tools can be fully integrated into HF clinical care pathway.

Original language	English
Article number	58
Number of pages	12
Journal	Heart Failure Reviews
Volume	31
Issue number	1
Early online date	16 Apr 2026
DOIs	https://doi.org/10.1007/s10741-026-10625-3
Publication status	E-pub ahead of print - 16 Apr 2026

Bibliographical note

This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/4.0/)
Under this licence, users are permitted to share, download, copy, and redistribute the material in any medium or format, and—where applicable—adapt or build upon the work, provided they comply with the conditions of the stated licence

Funding

The study received funding from the European Union’s Horizon Europe research and innovation programme under grant agreement number 101080905, and UK Research and Innovation grant award with reference number 10073472. Renae J Stefanetti is supported by the National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC). The NIHR Newcastle BRC is a partnership between Newcastle Hospitals NHS Foundation Trust, Newcastle University and Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust funded by the National Institute for Health and Care Research (NIHR). Views and opinions expressed are however those of the authors only and do not necessarily reflect those of the European Union, granting authority, NIHR or the Department of Health and Social Care.

Funders	Funder number
Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
NIHR Newcastle Biomedical Research Centre
Newcastle University
Newcastle upon Tyne NHS Hospitals Foundation Trust
Horizon Europe	101080905
UK Research and Innovation	10073472
NIHR Newcastle Biomedical Research Centre

Keywords

Vocal biomarkers
Screening
Novel technique
Heart failure
Risk stratification

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Fuller2026VoRFinal published version, 1.01 MBLicence: CC BY

Cite this

Fuller, A. S., Okwose, N. C., Charman, S. J., Voppel, A. E., Stefanetti, R. J., Groenewegen, A., Del Franco, A., Tafelmeier, M., Preveden, A., Milovancev, A., Edwards, D., Nelissen, A. P., Barlocco, F., Fornaro, A., Zamorano, J. L., Milli, M., Sasso, L., Taborchi, G., Bartolini, S., ... Jakovljevic, D. G. (2026). Voice recognition as an innovative method to identify and monitor heart failure – a review. Heart Failure Reviews, 31(1), Article 58. Advance online publication. https://doi.org/10.1007/s10741-026-10625-3

Fuller, AS , Okwose, NC, Charman, SJ, Voppel, AE, Stefanetti, RJ, Groenewegen, A, Del Franco, A, Tafelmeier, M, Preveden, A, Milovancev, A, Edwards, D, Nelissen, AP, Barlocco, F, Fornaro, A, Zamorano, JL, Milli, M, Sasso, L, Taborchi, G, Bartolini, S, Fatucchi, S, Banerjee, P, MacGowan, GA, Fernandez, O, Bravo, MJ-B, Maier, LS, Olivotto, I, Rutten, FH, Mant, J, Velicki, L, Seferovic, PM, Filipovic, N & Jakovljevic, DG 2026, 'Voice recognition as an innovative method to identify and monitor heart failure – a review', Heart Failure Reviews, vol. 31, no. 1, 58. https://doi.org/10.1007/s10741-026-10625-3

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abstract = "Screening of heart failure (HF) remains suboptimal. However, vocal biomarkers are an emerging tool to screen for HF and predict adverse outcomes. This article is a literature review of the current evidence, exploring the use of vocal biomarkers to screen for HF and predict hospitalisation and mortality. Voice may be utilised as a time-efficient method for the screening of HF, risk stratification, and monitoring of disease progression. Vocal biomarkers such as pause ratio and artificial neural networks can screen for HF accurately in a case-control setting. Other vocal markers like maximum phonation time, creak percent are useful to monitor disease progression. Vocal biomarkers appear to match current predictors of one-year mortality, HF related decompensation and hospitalisation. The integration of vocal biomarkers assessment in HF healthcare is promising across primary and secondary care settings. Key challenges including health data protection, regulatory compliance, and user acceptance must be addressed before these tools can be fully integrated into HF clinical care pathway.",

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AU - Voppel, Alban E.

AU - Stefanetti, Renae J.

AU - Groenewegen, Amy

AU - Del Franco, Annamaria

AU - Tafelmeier, Maria

AU - Preveden, Andrej

AU - Milovancev, Aleksandra

AU - Edwards, Duncan

AU - Nelissen, Anne P.

AU - Barlocco, Fausto

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AU - Zamorano, Jose Luis

AU - Milli, Massimo

AU - Sasso, Laura

AU - Taborchi, Giulia

AU - Bartolini, Simone

AU - Fatucchi, Serena

AU - Banerjee, Prithwish

AU - MacGowan, Guy A.

AU - Fernandez, Oscar

AU - Bravo, Marta Jimenez-Blanco

AU - Maier, Lars S.

AU - Olivotto, Iacopo

AU - Rutten, Frans H.

AU - Mant, Jonathan

AU - Velicki, Lazar

AU - Seferovic, Petar M.

AU - Filipovic, Nenad

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Voice recognition as an innovative method to identify and monitor heart failure – a review

Abstract

Bibliographical note

Funding

Keywords

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Cite this