The Memo: Noah Labs Listening for the Early Signs of Heart Failure Decompensation

Under the direction of Co-Founder and CEO Oliver Piepenstock, Noah Labs is developing a new approach to heart failure monitoring built around an unlikely source of clinical information: the human voice. The Boston- and Berlin-based company has developed Vox, an investigational AI-driven software medical device designed to detect vocal changes associated with worsening heart failure before hospitalization. Its deep learning models are trained on more than three million voice samples, while its commercially deployed Ark remote patient monitoring platform provides a foundation in clinical workflows and data. With Vox now advancing through a pivotal U.S. trial following FDA Breakthrough Device Designation, Noah Labs is working toward a larger vision Piepenstock describes as “the world’s first voice-powered operating system for heart failure care.”

Origin Story

Noah Labs began in Berlin in late 2021, when Piepenstock met Co-Founder and CTO Marcus Hott through Entrepreneur First. Their backgrounds brought two different perspectives to the same challenge.

Hott came from Harvard Medical School, where he had developed cardiac MRI sequences that are now deployed across U.S. health systems. Piepenstock had previously founded a healthcare startup in elderly care, giving him firsthand experience with the operational and regulatory challenges involved in scaling medical technology.

“When we began discussing the intersection of AI, cardiology, and patient monitoring, we recognized the same unmet need from two different angles,” Piepenstock said.

What emerged was the idea that voice could provide a largely untapped window into the pathophysiology of heart failure. Fluid accumulation in the lungs associated with acute decompensation can produce subtle changes in a patient’s voice, creating signals that machine learning may be able to detect.

“The core insight was simple but overlooked: voice contains measurable clinical information relevant to heart failure pathophysiology,” Piepenstock said. “Yet virtually no one had built a scalable, clinical-grade product around this signal.”

Dr. Leonhard Riehle joined Noah Labs as its third co-founder and CMO in 2024 after previously running remote monitoring programs and clinical research at Charité Berlin, adding clinical rigor to the founding team.

The Current Landscape

The need Noah Labs is addressing is significant. According to Piepenstock, heart failure accounts for roughly 1.2 million congestive heart failure hospitalizations annually in the U.S. and $28.2 billion in healthcare costs, averaging $22,000 per U.S. patient. The challenge is not simply managing diagnosed heart failure, but recognizing deterioration early enough to intervene.

“Today’s monitoring landscape is fragmented and inadequate,” Piepenstock said.

Approximately 61% of heart failure patients receive no monitoring whatsoever, according to the company. For those who are monitored, existing options occupy opposite ends of the spectrum. Weight monitoring is inexpensive and widely accessible, but Piepenstock said it has less than 30% sensitivity and typically provides only about three to five days of warning before hospitalization.  Implantable hemodynamic monitors can provide far greater precision, but at approximately $25,000 per device, he said they reach fewer than 1% of heart failure patients.

The result is a substantial population without an effective early warning system. That gap carries serious consequences. Piepenstock cited a 32% readmission rate within 90 days of discharge and noted that one-third of heart failure patients die within one year of a hospitalization event.

For Noah Labs, the opportunity is to create another option between low-sensitivity conventional monitoring and costly invasive technology.

This blog is originally published here: https://www.lifesciencemarketresearch.com/insights/the-memo-noah-labs-listening-for-the-early-signs-of-heart-failure-decompensation