Investigation of Acoustic Cardiographic Parameters before and after Hemodialysis

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.

Value of acoustic cardiography in the clinical diagnosis of coronary heart disease

“…[20][21][22][23] Other studies show that monitoring with acoustic cardiography can be used as a fast, simple, and effective method to predict early systolic dysfunction and to screen patients with sleep apnea syndrome. [24][25][26] In conclusion, S4 strength combined with ST-T changes of the ECG can improve the diagnosis of coronary heart disease; Acoustic cardiography can be used as a fast, simple, inexpensive and effective method to diagnose asymptomatic LVSD in the early weeks after AMI.…”

Changes in acoustic cardiographic parameters before and after hemodialysis are associated with overall and cardiovascular mortality in hemodialysis patients

“…Our recent study investigated ACPs in hemodialysis (HD) patients before and after HD, and found that the fourth heart sound (S4) and LV systolic time (LVST) were decreased and electromechanical activation time (EMAT) was increased after HD 11 . However, whether changes in ACPs before and after HD (△ACPs) can be used as a prognosis marker remains to be determined.…”