Diagnostic Characteristics of Combining Phonocardiographic Third Heart Sound and Systolic Time Intervals for the Prediction of Left Ventricular Dysfunction

Shapiro, Mia; Moyers, Brian; Marcus, Gregory M.; Gerber, Ivor L.; McKeown, B.; Vessey, Joshua C.; Jordan, Mark V.; Huddleston, Michele; Foster, Elyse; Chatterjee, Kanu; Michaels, Andrew D.

doi:10.1016/j.cardfail.2006.09.009

Cited by 32 publications

(27 citation statements)

References 39 publications

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“…The ability of acoustic cardiography to detect diaphragmatic muscular movement in the form of a sound artifact has been recently shown 17 . In addition, acoustic cardiography generates both systolic and diastolic parameters that accurately reflect left ventricular function 18–25 . Therefore, the same technique used to document the presence of PNS would also be used to evaluate its cardiovascular effects.…”

mentioning

confidence: 99%

Detection and Hemodynamic Significance of Cardiac Pacemaker–Induced Phrenic Nerve Stimulation

Züber

Roos

Kobza

et al. 2010

Congestive Heart Failure

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The authors investigated acoustic cardiography, the digital analysis of electrocardiogram (ECG) and heart sounds, to detect phrenic nerve stimulation (PNS) and assess its hemodynamic significance. They studied 42 patients and induced 46 instances of PNS induced through cardiac pacing at various locations in the heart. These 46 instances of PNS were either independently documented using fluoroscopy or were symptomatic. The authors collected acoustic cardiography data including the electromechanical activation time (interval from Q onset to the first heart sound [S1]) as a percentage of the RR interval (%EMAT) to assess systolic function. Acoustic cardiography provided evidence of PNS when it occurred. They also found significant %EMAT prolongation when right ventricular pacing was associated with PNS (Delta%EMAT=2.7, P=.012), but none beyond the normal range with right ventricular pacing in the absence of PNS. Documented PNS occurred in 33 episodes (60%) in patients with noticeable symptoms. Stimulation amplitudes could be found that generated asymptomatic PNS for all of the five participants explicitly tested for it. PNS can be asymptomatic. PNS due to right ventricular pacing is associated with impaired left ventricular systolic function. Acoustic cardiography is an effective method of detecting and assessing the hemodynamic significance of pacemaker-related PNS.

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mentioning

confidence: 99%

Detection and Hemodynamic Significance of Cardiac Pacemaker–Induced Phrenic Nerve Stimulation

Züber

Roos

Kobza

et al. 2010

Congestive Heart Failure

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“…An alternative parameter for evaluating cardiac systolic performance is STI20, Patients with decreased LVEF and left ventricular contractility have a long PEP, a shortened ET, and a long PEP/ET152021. Various STIs measured by non-invasive sphygmography, phonocardiography, peripheral arterial waveform recordings, or echocardiography reportedly have significant correlations with LVEF161722232425. Clinical applications of STI have been reported in various cardiac diseases, including heart failure, coronary artery disease, and hypertension142627.…”

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confidence: 99%

Renal systolic time intervals derived from intra-renal artery Doppler as a novel predictor of adverse cardiac outcomes

Lee

Hsu

Chu

et al. 2017

Sci Rep

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The aim of this study was to evaluate the use of renal systolic time intervals measured by electrocardiographic gated Doppler ultrasonography for predicting adverse cardiac events. This longitudinal observation study enrolled 205 patients. Renal systolic time intervals, including pre-ejection period (PEP) and ejection time (ET), and ratio of renal PEP to ET, were measured by electrocardiographic gated Doppler ultrasound. The 14 adverse cardiac events identified in this population included 9 cardiac deaths and 5 hospitalizations for heart failure during an average follow up of 30.9 months (25th–75th percentile: 30–33 months). Renal PEP (hazard ratio = 1.023, P = 0.001), renal ET (hazard ratio = 0.975, P = 0.001) and renal PEP/ET (per 0.01 unit increase, hazard ratio = 1.060, P < 0.001) were associated with poor cardiac outcomes. The addition of renal PEP/ET to a Cox model containing important clinical variables and renal resistive index further improved the value in predicting adverse cardiac events (Chi-square increase, 9.996; P = 0.002). This study showed that parameters of intra-renal hemodynamics were potential predictors of adverse cardiac outcomes. However, the generalizability of these indicators need to be investigated in future large-scale studies.

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“…The parameters that were significant predictors in the multivariable model included both ECG and acoustic cardiographic variables. LV systolic time interval has been shown to correlate with LV failure 18,19 . QRS duration and QR duration have been shown to be specific for LV dysfunction 20,21 .…”

Section: Discussionmentioning

confidence: 99%

Noninvasive Prediction of Left Ventricular Systolic Dysfunction in Patients With Clinically Suspected Heart Failure Using Acoustic Cardiography

Kosmicki

Collins

Kontos

et al. 2010

Congestive Heart Failure

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The signs and symptoms of systolic heart failure are frequently insensitive and nonspecific, making an accurate bedside diagnosis of left ventricular systolic dysfunction (LVSD) challenging. B-type natriuretic peptide (BNP) is often used, but is not diagnostically useful when in the indeterminate range. The authors investigated the diagnostic test characteristics of acoustic cardiographic parameters to identify patients with LVSD. Four hundred thirty-three patients with contemporaneous measurements of computerized acoustic cardiography, BNP, and echocardiography were included. The acoustic cardiographic model outperformed BNP alone at detecting reduced left ventricular ejection fraction (C statistic, 0.88 vs 0.67; P<.0001). The acoustic model with BNP did not perform better than the acoustic model alone (P=.14). Within the indeterminate BNP range, the acoustic model outperformed BNP (C statistic, 0.89 vs 0.64; P<.0001). Noninvasive computerized acoustic cardiography predicted LVSD in a diverse population. This acoustic cardiographic model outperformed BNP alone for predicting LVSD.

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Diagnostic Characteristics of Combining Phonocardiographic Third Heart Sound and Systolic Time Intervals for the Prediction of Left Ventricular Dysfunction

Cited by 32 publications

References 39 publications

Detection and Hemodynamic Significance of Cardiac Pacemaker–Induced Phrenic Nerve Stimulation

Detection and Hemodynamic Significance of Cardiac Pacemaker–Induced Phrenic Nerve Stimulation

Renal systolic time intervals derived from intra-renal artery Doppler as a novel predictor of adverse cardiac outcomes

Noninvasive Prediction of Left Ventricular Systolic Dysfunction in Patients With Clinically Suspected Heart Failure Using Acoustic Cardiography

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