Utility of a bedside acoustic cardiographic model to predict elevated left ventricular filling pressure

Collins, Sean P.; Kontos, Michael C.; Michaels, Andrew D.; Züber, Michel; Kipfer, Peter; Jost, Christine Attenhofer; Roos, Marcus; Jamshidi, Paul; Erné, Paul; Lindsell, Christopher J.

doi:10.1136/emj.2009.080150

Cited by 12 publications

(12 citation statements)

References 21 publications

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“…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.…”

Section: Discussionmentioning

confidence: 87%

“…[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.…”

Section: Introductionmentioning

confidence: 99%

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

Walia

Vicera

Lin

et al. 2019

Pacing Clinical Electrophis

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Background Premature ventricular contractions (PVCs) induced by subtle cardiac dysfunction are missed by echocardiography. We evaluated acoustic cardiography for detection of early electromechanical dysfunction in patients with idiopathic PVCs and normal left ventricular ejection fraction (LVEF), and investigated the impact of radiofrequency ablation (RFA) in reversing this adverse effect. Methods Eighty‐six patients with PVCs and 33 normal controls having normal LVEF were studied. Fifty PVC patients were in the ablation group and 36 in the nonablation group. %Electromechanical activation time (%EMAT), %left ventricular systolic time (%LVST), third (S3) and fourth heart sound (S4), and systolic dysfunction index (SDI) during sinus rhythm (SR) were measured by acoustic cardiography (Audicor, Inovise Medical, Inc., Beaverton, OR, USA) pre‐ and postablation. In 28 patients, acoustic parameters were compared during SR without PVCs, and SR with single PVC, ≥ 2 PVCs, or ventricular tachycardia over 10‐second Audicor recording in a single patient at different times. Twenty‐four‐hour acoustic cardiographic and acoustic cardiographic Holter recording were used to assess the impact of PVC burden on electromechanical function in 41 patients. Results %EMAT, S3, S4, and SDI showed significant worsening in the PVC versus control group. %EMAT and SDI were worsened with increasing PVC number in a 10‐second strip. %EMAT showed significant linear increment with increasing PVC burden. There was a significant improvement in %EMAT, %LVST, S3, S4, and SDI postablation in patients with PVCs. Conclusion Acoustic cardiography can detect PVC‐induced minor electromechanical dysfunction in patients with normal LVEF. RFA can reverse this adverse effect.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

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

Walia

Vicera

Lin

et al. 2019

Pacing Clinical Electrophis

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“…Since the S3 has a high specificity, acoustic cardiography has a potential in the evaluation of potential heart failure patients. In patients who had a right heart catheterization, the use of acoustic cardiography predicted a PCWP C15 mmHg (c-stat 0.76) [5]. The Heart Failure and Audicor Technology for Rapid Diagnosis and Initial Treatment (HEARD-IT) trial investigated the use of acoustic cardiography S3 in 995 dyspneic patients and found that for acoustic cardiography the S3 had a sensitivity of 40.2 % and a specificity of 88.5 % [6].…”

Section: Acoustic Cardiographymentioning

confidence: 99%

Fluid-Volume Assessment in the Investigation of Acute Heart Failure

Tuy

Than

2013

Curr Emerg Hosp Med Rep

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Heart failure is a syndrome whereby cardiac function is incapable of providing for the body's circulatory demands, resulting in hemodynamic and volumetric aberrations. Acute heart failure (AHF) is the condition where signs and symptoms of heart failure are present that require urgent intervention. In AHF impaired cardiac function progresses to hemodynamic congestion and eventually develops into a fluid overloaded state. These patients will typically present acutely for medical assistance, with signs and symptoms of fluid overload (dyspnea, paroxysmal nocturnal dyspnea, orthopnea, edema, etc.) and/or hypoperfusion (malaise, altered mental status, decreased urine output). In patients with AHF, volume assessment is a crucial step in the initial diagnosis.

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“… 6 Because LVD usually prolongs the electromechanical activation time (EMAT) and shortens the left ventricular ejection time (LVET), a number of clinical studies have demonstrated their value for assessing left ventricular performance in patients with heart failure. 7 – 9 However, it remains uncertain whether systolic time intervals are useful in detecting LVD in the particular setting of AECOPD where LVD could be easily underdiagnosed.…”

Section: Introductionmentioning

confidence: 99%

Systolic time intervals combined with Valsalva maneuver for the diagnosis of left ventricular dysfunction in COPD exacerbations

Boubaker

Grissa

Beltaïef

et al. 2016

COPD

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BackgroundThe goal of this study was to determine the value of systolic time intervals and their change during Valsalva maneuver (VM) in the diagnosis of left ventricular dysfunction (LVD) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).MethodsWe included 166 patients admitted to the emergency department for AECOPD. Measurement of systolic time intervals included electromechanical activation time (EMAT), left ventricular ejection time (LVET), and EMAT/LVET ratio. These were performed at baseline and during the first strain phase of the VM using a computerized phonoelectrocardiographic method. The diagnosis of LVD was determined on the basis of clinical examination, echocardiography, and brain natriuretic peptide. The values of systolic time intervals were compared between patients with and without LVD; their diagnostic performance was assessed using the area under receiver operating characteristic (ROC) curve.ResultsPatients with LVD (n=95) had a significantly higher EMAT and lower LVET and EMAT/LVET ratio compared to patients without LVD (n=71); the area under ROC curve was 0.79, 0.88, and 0.90, respectively, for EMAT, LVET, and EMAT/LVET ratio. All baseline systolic time intervals changed significantly during VM in patients without LVD but they did not change in patients with LVD. The area under ROC curve increased to 0.84 and 0.93, respectively, for EMAT and EMAT/LVET ratio but did not change for LVET.ConclusionSimple and noninvasive measurements of systolic time intervals combined with VM could be helpful to detect or rule out LVD in patients admitted to the emergency room for COPD excacerbation. The EMAT/LVET ratio seems to have the best diagnostic value.

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Utility of a bedside acoustic cardiographic model to predict elevated left ventricular filling pressure

Cited by 12 publications

References 21 publications

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

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

Fluid-Volume Assessment in the Investigation of Acute Heart Failure

Systolic time intervals combined with Valsalva maneuver for the diagnosis of left ventricular dysfunction in COPD exacerbations

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