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Huecker M, Schutzman C, French J, El-Kersh K, Ghafghazi S, Desai R, Frick D, Thomas JJ. Accurate Modeling of Ejection Fraction and Stroke Volume With Mobile Phone Auscultation: Prospective Case-Control Study. JMIR Cardio 2024; 8:e57111. [PMID: 38924781 PMCID: PMC11237790 DOI: 10.2196/57111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/19/2024] [Accepted: 04/10/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Heart failure (HF) contributes greatly to morbidity, mortality, and health care costs worldwide. Hospital readmission rates are tracked closely and determine federal reimbursement dollars. No current modality or technology allows for accurate measurement of relevant HF parameters in ambulatory, rural, or underserved settings. This limits the use of telehealth to diagnose or monitor HF in ambulatory patients. OBJECTIVE This study describes a novel HF diagnostic technology using audio recordings from a standard mobile phone. METHODS This prospective study of acoustic microphone recordings enrolled convenience samples of patients from 2 different clinical sites in 2 separate areas of the United States. Recordings were obtained at the aortic (second intercostal) site with the patient sitting upright. The team used recordings to create predictive algorithms using physics-based (not neural networks) models. The analysis matched mobile phone acoustic data to ejection fraction (EF) and stroke volume (SV) as evaluated by echocardiograms. Using the physics-based approach to determine features eliminates the need for neural networks and overfitting strategies entirely, potentially offering advantages in data efficiency, model stability, regulatory visibility, and physical insightfulness. RESULTS Recordings were obtained from 113 participants. No recordings were excluded due to background noise or for any other reason. Participants had diverse racial backgrounds and body surface areas. Reliable echocardiogram data were available for EF from 113 patients and for SV from 65 patients. The mean age of the EF cohort was 66.3 (SD 13.3) years, with female patients comprising 38.3% (43/113) of the group. Using an EF cutoff of ≤40% versus >40%, the model (using 4 features) had an area under the receiver operating curve (AUROC) of 0.955, sensitivity of 0.952, specificity of 0.958, and accuracy of 0.956. The mean age of the SV cohort was 65.5 (SD 12.7) years, with female patients comprising 34% (38/65) of the group. Using a clinically relevant SV cutoff of <50 mL versus >50 mL, the model (using 3 features) had an AUROC of 0.922, sensitivity of 1.000, specificity of 0.844, and accuracy of 0.923. Acoustics frequencies associated with SV were observed to be higher than those associated with EF and, therefore, were less likely to pass through the tissue without distortion. CONCLUSIONS This work describes the use of mobile phone auscultation recordings obtained with unaltered cellular microphones. The analysis reproduced the estimates of EF and SV with impressive accuracy. This technology will be further developed into a mobile app that could bring screening and monitoring of HF to several clinical settings, such as home or telehealth, rural, remote, and underserved areas across the globe. This would bring high-quality diagnostic methods to patients with HF using equipment they already own and in situations where no other diagnostic and monitoring options exist.
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Affiliation(s)
- Martin Huecker
- Department of Emergency Medicine, University of Louisville, Louisville, KY, United States
| | - Craig Schutzman
- Department of Emergency Medicine, University of Louisville, Louisville, KY, United States
| | - Joshua French
- Department of Emergency Medicine, University of Louisville, Louisville, KY, United States
| | - Karim El-Kersh
- Department of Pulmonary and Critical Care Medicine, The University of Arizona, Phoenix, AZ, United States
| | - Shahab Ghafghazi
- Department of Emergency Medicine, University of Louisville, Louisville, KY, United States
| | - Ravi Desai
- Lehigh Valley Health Network Cardiology and Critical Care, Allentown, PA, United States
| | - Daniel Frick
- Department of Emergency Medicine, University of Louisville, Louisville, KY, United States
| | - Jarred Jeremy Thomas
- Department of Emergency Medicine, University of Louisville, Louisville, KY, United States
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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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Gicana KRB, Lertwanakarn T, Tachampa K. Novel Approach to Assess Cardiac Function Using Systolic Performance and Myocardial Performance Indices From Simultaneous Electrocardiography and Phonocardiography Recordings in Dogs With Various Stages of Myxomatous Mitral Valve Disease. Front Vet Sci 2021; 8:741115. [PMID: 34746282 PMCID: PMC8566337 DOI: 10.3389/fvets.2021.741115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Objective: Myxomatous mitral valve disease (MMVD) progression entails changes in the structural and functional properties of the heart affecting cardiac timings and intervals within the cardiac cycle. Conventionally, echocardiography is used to determine the cardiac time intervals (CTIs) including systolic and myocardial performance indices (SPI and MPI) in evaluating cardiac function. Alternatively, these CTIs can also be measured using simultaneous recordings of electrocardiography (ECG) and phonocardiography (PCG), but their values in different MMVD stages remain to be established. This study aimed to establish and prove the use of derived SPI and MPI from a dedicated device as a novel approach to assess cardiac function in different stages of MMVD dogs. Materials and Methods: A prospective study in 52 dogs with different MMVD stages measured the CTIs using a novel device. These were compared and correlated with standard echocardiographic parameters. The predictive value of SPI and three new proposed formulas to estimate MPI (i.e., F1, F2, and F3) in association with asymptomatic from symptomatic MMVD dogs were investigated. Results: Our findings revealed that CTI parameters measured from a novel device including QS1, QS2, S1S2, MPI-F1, and MPI-F2 were altered at different stages of MMVD. The SPI and all proposed MPI formulas were comparable with the systolic time interval and Tei index from echocardiography. In addition, the SPI, MPI-F1, and MPI-F2 were significantly correlated with the Tei index. However, the SPI was not able to differentiate the various stages of MMVD. Conversely, only the MPI-F1 (i.e., (QS1 + S2)/S1S2) demonstrated good predictive accuracy when compared between asymptomatic and symptomatic MMVD dogs similar to the Tei index. Moreover, this formula was able to differentiate stages B1 and C with remarkable predictive accuracy, higher sensitivity, and high specificity when compared with the Tei index. Conclusion: We have successfully described the CTI parameters in different MMVD stages using simultaneous ECG and PCG recordings in dogs. Furthermore, we have proven that the concept of using the newly proposed parameters from a novel device is equivalent to the Tei index. Thus, we established a novel approach to evaluate cardiac function and its supportive use in the diagnosis of MMVD patients.
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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, Los Baños, Philippines
| | - Tuchakorn Lertwanakarn
- Department of Physiology, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - Kittipong Tachampa
- Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
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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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Pan KL, Chang SL, Lin YJ, Lo LW, Hu YF, Chung FP, Chao TF, Liao JN, Lin CY, Lin CH, Te ALD, Yamada S, Chang YT, Chen SA. Left Ventricular Electromechanical Remodeling Detected by Acoustic Cardiography in Paroxysmal Atrial Fibrillation. J Cardiovasc Transl Res 2020; 14:348-354. [PMID: 32557157 DOI: 10.1007/s12265-020-10047-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 06/08/2020] [Indexed: 11/30/2022]
Abstract
This study aimed to investigate the electromechanical function detected by acoustic cardiography before and after radiofrequency ablation therapy (RFA) in paroxysmal AF (PAF) patients with preserved left ventricular ejection fraction (LVEF). Seventy-five symptomatic PAF patients and 69 patients without arrhythmia were enrolled. Thirty-seven PAF patients received RFA therapy. Acoustic cardiographic exam was performed to check S3 and S4 heart sound, electromechanical activation time (EMAT), LV systolic time percentage (LVST), and systolic dysfunction index (SDI) in all participants. Furthermore, 37 PAF patients also received follow-up acoustic cardiography postRFA. PAF had impaired electromechanical systolic function compared with health participants (%EMAT 14.69 ± 3.62 vs. 10.84 ± 2.62; %LVST 40.83 ± 5.14 vs. 36.70 ± 3.87; SDI 4.75 ± 1.61 vs. 3.26 ± 0.96 all p < 0.001). RFA can improve electromechanical systolic function. Improvement below 13.1% could predict the recurrent AF postcatheter ablation. Higher degree of improved electromechanical systolic function postRFA contribute to lower recurrence of AF. Graphical Abstract Receiver operating characteristic (ROC) curve analysis for % change of systolic dysfunction index (SDI) postRFA in the detection of recurrent AF.
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Affiliation(s)
- Kuo-Li Pan
- Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Heart Failure Center, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan
| | - Shih-Lin Chang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201 Section 2, Shih-Pai Road, Taipei, Taiwan.
- School of Medicine, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Yenn-Jiang Lin
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201 Section 2, Shih-Pai Road, Taipei, Taiwan
- School of Medicine, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Li-Wei Lo
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201 Section 2, Shih-Pai Road, Taipei, Taiwan
- School of Medicine, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Feng Hu
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201 Section 2, Shih-Pai Road, Taipei, Taiwan
- School of Medicine, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Fa-Po Chung
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201 Section 2, Shih-Pai Road, Taipei, Taiwan
- School of Medicine, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tze-Fan Chao
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201 Section 2, Shih-Pai Road, Taipei, Taiwan
- School of Medicine, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jo-Nan Liao
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201 Section 2, Shih-Pai Road, Taipei, Taiwan
- School of Medicine, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chin-Yu Lin
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201 Section 2, Shih-Pai Road, Taipei, Taiwan
- School of Medicine, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chung-Hsing Lin
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan
| | | | - Shinya Yamada
- Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan
| | - Yao-Ting Chang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201 Section 2, Shih-Pai Road, Taipei, Taiwan
- School of Medicine, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Ann Chen
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, 201 Section 2, Shih-Pai Road, Taipei, Taiwan
- School of Medicine, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
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Investigation of Acoustic Cardiographic Parameters before and after Hemodialysis. DISEASE MARKERS 2019; 2019:5270159. [PMID: 31781303 PMCID: PMC6874870 DOI: 10.1155/2019/5270159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 10/22/2019] [Indexed: 01/20/2023]
Abstract
Patients with end-stage renal disease are at an increased risk of cardiovascular diseases and associated mortality. Acoustic cardiography is a technique in which cardiac acoustic data is synchronized with electric information to detect and characterize heart sounds and detect heart failure early. The aim of this study was to investigate acoustic cardiographic parameters before and after hemodialysis (HD) and their correlations with ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), and ratio of brachial preejection period to ejection time (bPEP/bET) obtained from an ABI-form device in HD patients. This study enrolled 162 HD patients between October 2016 and April 2018. Demographic, medical, and laboratory data were collected. Acoustic cardiography was performed before and after HD to assess parameters including third heart sound (S3), fourth heart sound (S4), systolic dysfunction index (SDI), electromechanical activation time (EMAT), and left ventricular systolic time (LVST). The mean age of the enrolled patients was 60.4 ± 10.9 years, and 86 (53.1%) patients were male. S4 (p < 0.001) and LVST (p < 0.001) significantly decreased after HD, but EMAT (p < 0.001) increased. Multivariate forward linear regression analysis showed that EMAT/LVST before HD was negatively associated with albumin (unstandardized coefficient β = ‐0.076; p = 0.004) and ABI (unstandardized coefficient β = ‐0.115; p = 0.011) and positively associated with bPEP/bET (unstandardized coefficient β = 0.278; p = 0.003). Screening HD patients with acoustic cardiography may help to identify patients at a high risk of malnutrition, peripheral artery disease, and left ventricular systolic dysfunction.
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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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Walia R, Chang S, Lin Y, Lo L, Hu YF, Chao T, Chung F, Liao J, Lin C, Chang Y, Lin C, Te ALD, Yamada S, Chen S, Tsao H. Early detection of electromechanical dysfunction in patients with idiopathic premature ventricular contractions. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2019; 42:637-645. [DOI: 10.1111/pace.13650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 11/15/2018] [Accepted: 02/11/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Rohit Walia
- Division of Cardiology, Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
| | - Shih‐Lin Chang
- Division of Cardiology, Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
- Department of MedicineNational Yang‐Ming University School of Medicine Taipei Taiwan
| | - Yenn‐Jiang Lin
- Division of Cardiology, Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
- Department of MedicineNational Yang‐Ming University School of Medicine Taipei Taiwan
| | - Li‐Wei Lo
- Division of Cardiology, Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
- Department of MedicineNational Yang‐Ming University School of Medicine Taipei Taiwan
| | - Yu Feng Hu
- Division of Cardiology, Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
- Department of MedicineNational Yang‐Ming University School of Medicine Taipei Taiwan
| | - Tze‐Fan Chao
- Division of Cardiology, Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
- Department of MedicineNational Yang‐Ming University School of Medicine Taipei Taiwan
| | - Fa‐Po Chung
- Division of Cardiology, Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
- Department of MedicineNational Yang‐Ming University School of Medicine Taipei Taiwan
| | - Jo‐Nan Liao
- Division of Cardiology, Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
- Department of MedicineNational Yang‐Ming University School of Medicine Taipei Taiwan
| | - Chin‐Yu Lin
- Division of Cardiology, Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
- Department of MedicineNational Yang‐Ming University School of Medicine Taipei Taiwan
| | - Yao‐Ting Chang
- Division of Cardiology, Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
- Department of MedicineNational Yang‐Ming University School of Medicine Taipei Taiwan
| | - Chung‐Hsing Lin
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of MedicineTaipei Medical University Taipei Taiwan
- Division of Cardiology, Department of MedicineTaipei Medical University, Shuang Ho Hospital Taipei Taiwan
| | - Abigail Louise D. Te
- Division of Cardiology, Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
| | - Shinya Yamada
- Division of Cardiology, Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
| | - Shih‐Ann Chen
- Division of Cardiology, Department of MedicineTaipei Veterans General Hospital Taipei Taiwan
- Department of MedicineNational Yang‐Ming University School of Medicine Taipei Taiwan
| | - Hsuan‐Ming Tsao
- Department of MedicineNational Yang‐Ming University School of Medicine Taipei Taiwan
- Division of CardiologyNational Yang ‐ Ming University Hospital Yilan Taiwan
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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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