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Gicana KRB, Pinidmontree C, Kosalathip K, Sirirut S, Komolvanich S, Asawakarn S, Sakcamduang W, Naiyanetr P, Tachampa K. Use of proposed systolic and myocardial performance indices derived from simultaneous ECG and PCG recordings to assess cardiac function in healthy Beagles. Vet World 2022; 15:1785-1797. [PMID: 36185531 PMCID: PMC9394128 DOI: 10.14202/vetworld.2022.1785-1797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 06/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: Cardiac time intervals (CTIs) can provide important information on the electrical and mechanical properties of the heart. We hypothesized that cardiac function can be described using the combined power of electrocardiography (ECG) and phonocardiography (PCG) signals. This study aimed to (1) validate a novel custom device in measuring CTI parameters; (2) compare CTI parameters with a commercially available device and standard transthoracic echocardiography (STE); and (3) compare calculated systolic performance index (SPI) and myocardial performance index (MPI) with Tei index from the STE. Materials and Methods: This study determined CTIs based on simultaneous ECG and PCG recordings in 14 healthy Beagle dogs using the custom-built device. These CTI parameters were compared with a commercially available device (Eko DUO ECG + Digital Stethoscope; Eko DUO) and the STE. Agreement of CTI parameters between the custom device and the commercially available device or STE was evaluated. Calculated SPI and MPI based on Wigger’s diagram were proposed, compared with SPI and Tei index, and correlated with STE parameters. Results: We found that the ECG and PCG parameters measured from the custom-built device did not differ from the commercially available device and the STE. By combining ECG and PCG signals, we established CTI parameters in healthy dogs including indices for systolic function (SPI: QS1/S1S2) and global cardiac function {F1 ([QS1+S2]/S1S2), F2 ([RS1+S2]/S1S2), and F3 (RS1 + [QS2-QT]/S1S2)}. The SPI, F2, and F3 were comparable with echocardiographic parameters describing systolic (Pre-ejection period/left ventricular ejection time [LVET]) and Tei index ([MCOdur-LVET]/LVET), respectively. Only SPI and F3 were correlated significantly with MCOdur and heart rate, respectively. Conclusion: We have validated the use of the custom-built device to describe CTIs that are comparable to the commercially available device and STE in healthy Beagles. The proposed SPI and MPI derived from CTI parameters can be useful in clinical practice to describe the cardiac function, especially in areas where access to STE is constrained.
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Affiliation(s)
- Karlo Romano B. Gicana
- The International Graduate Program of Veterinary Science and Technology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand; Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of the Philippines Los Baños, Laguna, Philippines
| | - Chirutchaya Pinidmontree
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Kitchanan Kosalathip
- Cardiovascular Engineering and Artificial Organs (CardioArt) Laboratory, Department of Biomedical Engineering Department, Mahidol University, Nakhon Pathom, Thailand
| | - Siraphop Sirirut
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Siripen Komolvanich
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Sariya Asawakarn
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand; Biomarkers in Animal Parasitology Research Group, Chulalongkorn University, Bangkok, Thailand
| | - Walasinee Sakcamduang
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | - Phornphop Naiyanetr
- Cardiovascular Engineering and Artificial Organs (CardioArt) Laboratory, Department of Biomedical Engineering Department, Mahidol University, Nakhon Pathom, Thailand
| | - Kittipong Tachampa
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand; Biomarkers in Animal Parasitology Research Group, Chulalongkorn University, Bangkok, Thailand
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Huang J, Zhang W, Pan C, Zhu S, Mead RH, Li R, He B. Mobile Cardiac Acoustic Monitoring System to Evaluate Left Ventricular Systolic Function in Pacemaker Patients. J Clin Med 2022; 11:jcm11133862. [PMID: 35807146 PMCID: PMC9267668 DOI: 10.3390/jcm11133862] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/17/2022] [Accepted: 06/30/2022] [Indexed: 11/16/2022] Open
Abstract
The mobile cardiac acoustic monitoring system is a promising tool to enable detection and assist the diagnosis of left ventricular systolic dysfunction (LVSD). The objective of the study was to evaluate the diagnostic value of electromechanical activation time (EMAT), an important cardiac acoustic biomarker, in quantifying LVSD among left bundle branch pacing (LBBP) and right ventricular apical pacing (RVAP) patients using a mobile acoustic cardiography monitoring system. In this prospective single-center observational study, pacemaker-dependent patients were consecutively enrolled. EMAT, the time from the start of the pacing QRS wave to first heart sound (S1) peak; left ventricular systolic time (LVST), the time from S1 peak to S2 peak; and ECG were recorded simultaneously by the mobile cardiac acoustic monitoring system. LVEF was measured by echocardiography. A logistic regression model was applied to evaluate the association between EMAT and reduced EF (LVEF < 50%). A total of 105 pacemaker-dependent patients participated. The RVAP group (n = 58) displayed a significantly higher EMAT than the LBBP group (n = 47) (150.95 ± 19.46 vs. 108.23 ± 12.26 ms, p < 0.001). Pearson correlation analysis revealed a statistically significant negative correlation between EMAT and LVEF (p < 0.001). Survival analysis showed the sensitivity and specificity of detecting LVEF to be < 50% when EMAT ≥ 151 ms were 96.00% and 96.97% in the RVAP group. In LBBP patients, the sensitivity and specificity of using EMAT ≥ 110 ms as the cutoff value for the detection of LVEF < 50% were 75.00% and 100.00%. There was no significant difference in LVST with or without LVSD in the RVAP group (p = 0.823) and LBBP group (p = 0.086). Compared to LVST, EMAT was more helpful to identify LVSD in pacemaker-dependent patients. The cutoff point of EMAT for diagnosing LVEF < 50% differed regarding the pacing type. Therefore, the mobile cardiac acoustic monitoring system can be used to identify the progress of LVSD in pacemaker patients.
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Affiliation(s)
- Jingjuan Huang
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China; (J.H.); (W.Z.); (C.P.); (S.Z.); (B.H.)
| | - Weiwei Zhang
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China; (J.H.); (W.Z.); (C.P.); (S.Z.); (B.H.)
| | - Changqing Pan
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China; (J.H.); (W.Z.); (C.P.); (S.Z.); (B.H.)
| | - Shiwei Zhu
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China; (J.H.); (W.Z.); (C.P.); (S.Z.); (B.H.)
| | | | - Ruogu Li
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China; (J.H.); (W.Z.); (C.P.); (S.Z.); (B.H.)
- Correspondence:
| | - Ben He
- Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China; (J.H.); (W.Z.); (C.P.); (S.Z.); (B.H.)
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Fudim M, Mirro M, Cheng HM. Audicor Remote Patient Monitoring: FDA Breakthrough Device and Technology for Heart Failure Management. JACC Basic Transl Sci 2022; 7:313-315. [PMID: 35411320 PMCID: PMC8993761 DOI: 10.1016/j.jacbts.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Marat Fudim
- Duke University Hospital, Duke University Medical Center, 2301 Erwin Road, Durham, North Carolina 27710, USA @FudimMarat
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Zhang FW, Zhang YX, Si LY, Chen MS, Wang WW, Liang HR. Value of acoustic cardiography in the clinical diagnosis of coronary heart disease. Clin Cardiol 2021; 44:1386-1392. [PMID: 34486123 PMCID: PMC8495079 DOI: 10.1002/clc.23694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 07/05/2021] [Accepted: 07/15/2021] [Indexed: 12/31/2022] Open
Abstract
Background To investigate the clinical value of acoustic cardiography in the diagnosis of coronary artery disease (CAD) and post‐percutaneous coronary intervention (PCI) early asymptomatic left ventricular systolic dysfunction. Methods Inpatients in the department of cardiology were included in the research (n = 315); including 180 patients with angina pectoris and 135 patients with acute anterior wall myocardial infarction after emergency PCI did not present with signs and symptoms of heart failure. Color Doppler echocardiography, brain natriuretic peptide, acoustic cardiography examination were performed. The patients were divided into four groups: non‐CAD group (n = 60), CAD group (n = 120), MIREF group (EF% < 50%, n = 75), and MINEF group (EF% ≥ 50%, n = 60). Results Acoustic cardiography parameters EMATc, systolic dysfunction index, S3 strength and S4 strength in the MIREF group were higher than those in MINEF group (p < .05), and the MINEF group was higher than CAD group (p < .05). S3 strength (area under the curve [AUC] 0.67, 95% CI 0.585–0.755, p < .001) and S4 strength (AUC 0.617, 95% CI 0.536–0.698, p = .011) are useful in the diagnosis of CAD. S3 strength (AUC 0.942, 95% CI 0.807–0.978, p < .001) was superior to other indicators in the diagnosis of early left ventricular systolic dysfunction after myocardial infarction. Conclusion S4 combined with STT standard change can improve the diagnosis of CAD. Acoustic cardiography can be used as a non‐invasive, rapid, effective, and simple method for the diagnosis of asymptomatic left ventricular systolic dysfunction in the early stage after myocardial infarction.
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Affiliation(s)
- Fu Wei Zhang
- Division of Cardiology, Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yi Xue Zhang
- Division of Cardiology, Haikou People's Hospital, Central South University, Haikou, China
| | - Liang Yi Si
- Division of Cardiology, Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mo Shui Chen
- Division of Cardiology, Haikou People's Hospital, Central South University, Haikou, China
| | - Wei Wei Wang
- Division of Cardiology, Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hai Rong Liang
- Division of Cardiology, Haikou People's Hospital, Central South University, Haikou, China
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Changes in acoustic cardiographic parameters before and after hemodialysis are associated with overall and cardiovascular mortality in hemodialysis patients. Sci Rep 2021; 11:1559. [PMID: 33452428 PMCID: PMC7810842 DOI: 10.1038/s41598-021-81286-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/05/2021] [Indexed: 11/26/2022] Open
Abstract
Acoustic cardiography can provide simultaneous electrocardiography and acoustic cardiac data to assess the electronic and mechanical heart functions. The aim of this study was to assess whether changes in acoustic cardiographic parameters (ACPs) before and after hemodialysis (HD) are associated with overall and cardiovascular (CV) mortality in HD patients. A total of 162 HD patients was enrolled and ACPs were measured before and after HD, including left ventricular systolic time (LVST), systolic dysfunction index (SDI), third (S3) and fourth (S4) heart sounds, and electromechanical activation time (EMAT). During a follow-up of 2.9 years, 25 deaths occurred with 16 from CV causes. Multivariate analysis showed that high △SDI (per 1; hazard ratio [HR], 2.178; 95% confidence interval [CI], 1.189–3.990), high △EMAT (per 1%; HR, 2.218; 95% CI 1.382–3.559), and low △LVST (per 1 ms; HR, 0.947; 95% CI 0.912–0.984) were independently associated with increased overall mortality. In addition, high △EMAT (per 1%; HR, 2.141; 95% CI 1.117–4.102), and low △LVST (per 1 ms; HR, 0.777; 95% CI 0.637–0.949) were associated with increased CV mortality. In conclusion, the changes in ACPs before and after HD may be a useful clinical marker and stronger prognostic marker of overall and CV mortality than ACPs before HD.
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Effect of Acoustic Cardiography-guided Management on 1-year Outcomes in Patients With Acute Heart Failure. J Card Fail 2020; 26:142-150. [DOI: 10.1016/j.cardfail.2019.09.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 09/17/2019] [Accepted: 09/25/2019] [Indexed: 12/20/2022]
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Luciani M, Saccocci M, Kuwata S, Cesarovic N, Lipiski M, Arand P, Bauer P, Guidotti A, Regar E, Erne P, Zuber M, Maisano F. Reintroducing Heart Sounds for Early Detection of Acute Myocardial Ischemia in a Porcine Model - Correlation of Acoustic Cardiography With Gold Standard of Pressure-Volume Analysis. Front Physiol 2019; 10:1090. [PMID: 31507452 PMCID: PMC6713932 DOI: 10.3389/fphys.2019.01090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 08/07/2019] [Indexed: 11/18/2022] Open
Abstract
Background Acoustic cardiography is a hybrid technique that couples heart sounds recording with ECG providing insights into electrical-mechanical activity of the heart in an unsupervised, non-invasive and inexpensive manner. During myocardial ischemia hemodynamic abnormalities appear in the first minutes and we hypothesize a putative diagnostic role of acoustic cardiography for prompt detection of cardiac dysfunction for future patient management improvement. Methods and Results Ten female Swiss large white pigs underwent permanent distal coronary occlusion as a model of acute myocardial ischemia. Acoustic cardiography analyses were performed prior, during and after coronary occlusion. Pressure-volume analysis was conducted in parallel as an invasive method of hemodynamic assessment for comparison. Similar systolic and diastolic intervals obtained with the two techniques were significantly correlated [Q to min dP/dt vs. Q to second heart sound (r2 = 0.9583, p < 0.0001), PV diastolic filling time vs. AC perfusion time (r2 = 0.9686, p < 0.0001)]. Indexes of systolic and diastolic impairment correlated with quantifiable features of heart sounds [Tau vs. fourth heart sound Display Value (r2 = 0.2721, p < 0.0001) cardiac output vs. third heart sound Display Value (r2 = 0.0791 p = 0.0023)]. Additionally, acoustic cardiography diastolic time (AUC 0.675, p = 0.008), perfusion time (AUC 0.649, p = 0.024) and third heart sound Display Value (AUC 0.654, p = 0.019) emerged as possible indicators of coronary occlusion. Finally, these three parameters, when joined with heart rate into a composite joint-index, represent the best model in our experience for ischemia detection (AUC 0.770, p < 0.001). Conclusion In the rapidly evolving setting of acute myocardial ischemia, acoustic cardiography provided meaningful insights of mechanical dysfunction in a prompt and non-invasive manner. These findings should propel interest in resurrecting this technique for future translational studies as well as reconsidering its reintroduction in the clinical setting.
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Affiliation(s)
- Marco Luciani
- Department of Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Matteo Saccocci
- Department of Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Shingo Kuwata
- Department of Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Nikola Cesarovic
- Division of Surgical Research, University Hospital Zurich, Zurich, Switzerland
| | - Miriam Lipiski
- Division of Surgical Research, University Hospital Zurich, Zurich, Switzerland
| | | | - Peter Bauer
- VisCardia, Inc., Portland, OR, United States
| | - Andrea Guidotti
- Department of Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Evelyn Regar
- Department of Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Paul Erne
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Michel Zuber
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Francesco Maisano
- Department of Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland
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Montinari MR, Minelli S. The first 200 years of cardiac auscultation and future perspectives. J Multidiscip Healthc 2019; 12:183-189. [PMID: 30881010 PMCID: PMC6408918 DOI: 10.2147/jmdh.s193904] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Cardiac auscultation - even with its limitations - is still a valid and economical technique for the diagnosis of cardiovascular diseases, and despite the growing demand for sophisticated imaging techniques, clinical use of the stethoscope in medical practice has not yet been abandoned. In 1816, René-Théophile-Hyacinthe Laënnec invented the stethoscope, while examining a young woman with suspected heart disease, giving rise to mediated auscultation. He described in detail several heart and lung sounds, correlating them with postmortem pathology. Even today, a correct interpretation of heart sounds, integrated with the clinical history and physical examination, allows to detect properly most of the structural heart abnormalities or to evaluate them in a differential diagnosis. However, the lack of organic teaching of auscultation and its inadequate practice have a negative impact on the clinical competence of physicians in training, also reflecting a diminished academic interest in physical semiotic. Medical simulation could be an effective instructional tool in teaching and deepening auscultation. Handheld ultrasound devices could be used for screening or for integrating and improving auscultatory abilities of physicians; the electronic stethoscope, with its new digital capabilities, will help to achieve a correct diagnosis. The availability of innovative representations of the sounds with phono- and spectrograms provides an important aid in diagnosis, in teaching practice and pedagogy. Technological innovations, despite their undoubted value, must complement and not supplant a complete physical examination; clinical auscultation remains an important and cost-effective screening method for the physicians in cardiorespiratory diagnosis. Cardiac auscultation has a future, and the stethoscope has not yet become a medical heirloom.
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Affiliation(s)
- Maria Rosa Montinari
- Department of Biological and Environmental Science and Technology, University of Salento, Lecce, Italy,
| | - Sergio Minelli
- Department of Cardiology, Local Health Unit Lecce, Lecce, Italy
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Zuber N, Zuber M, Schwarzwald CC. Assessment of systolic and diastolic function in clinically healthy horses using ambulatory acoustic cardiography. Equine Vet J 2018; 51:391-400. [DOI: 10.1111/evj.13014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 08/21/2018] [Indexed: 12/13/2022]
Affiliation(s)
- N. Zuber
- Clinic for Equine Internal Medicine, Vetsuisse Faculty University of Zurich Zurich Switzerland
| | - M. Zuber
- Division of Cardiology University of Zurich Zurich Switzerland
| | - C. C. Schwarzwald
- Clinic for Equine Internal Medicine, Vetsuisse Faculty University of Zurich Zurich Switzerland
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NAM KYOUNGWON, AHN JIMIN, HWANG YOUNGJUN, JEON GYEROK, JANG DONGPYO, KIM INYOUNG. A PHONOCARDIOGRAM-BASED NOISE-ROBUST REAL-TIME HEART RATE MONITORING ALGORITHM FOR OUTPATIENTS DURING NORMAL ACTIVITIES. J MECH MED BIOL 2018. [DOI: 10.1142/s0219519418500446] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
For outpatients who need continuous monitoring of heart rate (HR) variation, it is important that HR can be monitored during normal activities such as speaking and walking. In this study, a noise-robust real-time HR monitoring algorithm based on phonocardiogram (PCG) signals is proposed. PCG signals were recorded using an electronic stethoscope; electrocardiogram (ECG) signals were recorded simultaneously with HR references. The proposed algorithm consisted of pre-processing, peak/nonpeak classification, voice noise processing, walking noise processing, and HR calculation. The performance of the algorithm was evaluated using PCG/ECG signals from 11 healthy participants. For comparison, the absolute errors between manually extracted ECG-based HR values and automatically calculated PCG-based HR values were calculated for the proposed algorithm and the comparison algorithm in two different test protocols. Experimental results showed that the average absolute errors of the proposed algorithm were 72.03%, 22.92%, and 36.39% of the values of the comparison algorithm for resting-state, speaking-state, and walking-state data, respectively, in protocol-1. In protocol-2, the average absolute error was 36.99% of that of the comparison algorithm. A total of 1102 cases in protocol-1 and 783 in protocol-2 had an absolute error [Formula: see text] beats per minute (BPM) using the comparison algorithm and an absolute error [Formula: see text] BPM using the proposed algorithm. On the basis of these results, we anticipate that the proposed algorithm can potentially improve the performance of continuous real-time HR monitoring during activities of normal life, thereby improving the safety of outpatients with cardiovascular diseases.
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Affiliation(s)
- KYOUNG WON NAM
- Division of Biomedical Engineering, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Biomedical Engineering, School of Medicine, Pusan National University, Yangsan, Korea
| | - JI MIN AHN
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
- Intelligent Robotics Research Center, Korea Electronics Technology Institute, Bucheon, Korea
| | - YOUNG JUN HWANG
- Department of Medical Science, School of Medicine, Pusan National University, Yangsan, Korea
| | - GYE ROK JEON
- Division of Biomedical Engineering, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Biomedical Engineering, School of Medicine, Pusan National University, Yangsan, Korea
- Department of Medical Science, School of Medicine, Pusan National University, Yangsan, Korea
| | - DONG PYO JANG
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - IN YOUNG KIM
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
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Erne P, Resink TJ, Mueller A, Coslovsky M, Kobza R, Conen D, Bauer P, Arand P. Use of acoustic cardiography immediately following electrical cardioversion to predict relapse of atrial fibrillation. J Atr Fibrillation 2017; 10:1527. [PMID: 29250219 DOI: 10.4022/jafib.1527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 02/19/2017] [Accepted: 05/14/2017] [Indexed: 11/10/2022]
Abstract
Predicting atrial fibrillation (AF) recurrence after successful electrical cardioversion (ECV) is difficult. The main aim of this study was to investigate whether acoustic cardiography (AUDICOR® 200) immediately post-ECV might provide indices for AF relapse following cardioversion. Acoustic cardiography parameters included Electromechanical Activation Time (EMAT), Left Ventricular Systolic Time (LVST), QRS duration, heart rate and third heart sound intensity (S3 Strength). We analysed data from 140 patients who underwent successful cardioversion and in whom AUDICOR results and echocardiographic measurements immediately after (baseline) ECV were available. Patients were prospectively followed-up at 4-6 weeks, 3 and 12 months post-ECV, and sinus rhythm maintenance was evaluated using acoustic cardiography and Holter electrocardiography. The effect of each baseline AUDICOR parameter on the hazard of AF relapse was investigated using Cox proportional hazards (PH) models. Fifty patients (35.7%) had AF relapse. Of all the AUDICOR parameters, only S3 Strength exhibited consistent predictive value. Increasing S3 Strength increased the hazard of relapse in a univariable Cox PH model (HR=2.52, p=0.003), and in two multivariable Cox PH model constructions (Model 1 excluded heart rate and Model II excluded EMAT/RR, LVST and LVST/RR) both of which included the parameters as continuous variables (Model I: HR=1.15, p=0.042; Model II: HR=1.14, p=0.045) or the parameters dichotomized according to suggested cut-points (Model I: HR=2.5, p=0.007; Model II: HR=2.09, p=0.031). In conclusion, this study suggests that acoustic cardiography may be a simple inexpensive and quantitative bedside method to assist in prediction of AF recurrence after ECV.
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Affiliation(s)
- Paul Erne
- Laboratory of Signal Transduction, Department of Biomedicine, Basel University Hospital and Basel University, Basel, Switzerland
| | - Therese J Resink
- Department of Cardiology, Luzerner Kantonsspital, Luzern, Switzerland
| | - Andrea Mueller
- Department of Cardiology, Luzerner Kantonsspital, Luzern, Switzerland
| | | | - Richard Kobza
- Department of Cardiology, Luzerner Kantonsspital, Luzern, Switzerland
| | - David Conen
- Department of Cardiology, Basel University Hospital, Basel, Switzerland.,Population Health Research Institute, McMaster University, Hamilton, Canada
| | - Peter Bauer
- Inovise Medical, Inc., Beaverton, Oregon, USA
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An innovative multi-level singular value decomposition and compressed sensing based framework for noise removal from heart sounds. Biomed Signal Process Control 2017. [DOI: 10.1016/j.bspc.2017.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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