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

Abstract

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.

Early detection of electromechanical dysfunction in patients with idiopathic premature ventricular contractions

“…No cutoff values for %EMAT, %LVST, S3, S4, and SDI were used. In previous studies, %EMAT > 15 and SDI > 5 were used to signify abnormal LVEF, but our study composed of normal LVEF patients and acoustic cardiography parameters were only mildly deranged but still improved postablation signifying early subtle LV dysfunction. Second, the acoustic parameters were compared among SR, single PVC, ≥ 2 PVC, and VT with the same patient.…”

“…Acoustic cardiography‐derived electromechanical activation time (EMAT) has been shown to correlate with invasive and echocardiographic measures of LV contractility – . Also, acoustic cardiography has been used to measure LV function in arrhythmias other than PVC in various clinical scenarios . The aim of the present study was to assess the role of acoustic cardiography in the detection of early electromechanical dysfunction in idiopathic PVC patients with normal LVEF, and access the role of RFA in reversing LV dysfunction.…”

“…[6][7] Also, acoustic cardiography has been used to measure LV function in arrhythmias other than PVC in various clinical scenarios. [7][8][9][10][11][12][13] The aim of the present study was to assess the role of acoustic cardiography in the detection of early electromechanical dysfunction in idiopathic PVC patients with normal LVEF, and access the role of RFA in reversing LV dysfunction. Figure 1.…”

Night‐time electromechanical activation time, pulsatile hemodynamics, and discharge outcomes in patients with acute heart failure

“…It has well been demonstrated that a prolonged EMAT is associated with reduced LVEF, but its prognostic role in patients with heart failure remains to be explored . We have firstly shown that a pre‐discharge 10 s snap‐shot %EMAT recorded during daytime correlated significantly with LVEF, Ea, Ea/Ees, and NT‐proBNP, and could predict post‐discharge events independently of LVEF, E/E′, and NT‐proBNP levels in 45 patients (89% male; mean age, 71.9 years; and range, 24 to 92; 37.8% with LVEF ≥ 50%) hospitalized for AHFS .…”

Phonocardiography: new opportunities in the light of digital technologies

“…У больных с промежуточными уровнями BNP добавление данных системы Audicor уве-личивало прогностическую ценность положительного ре-зультата с 53 до 80% [16]. При обследовании 433 пациентов акустическая кар-диография позволяла прогнозировать уменьшение ФВ ЛЖ при ЭхоКГ достоверно точнее, чем уровень BNP [17].…”