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• W2530548590 abstract "Current treatment of acute heart failure (AHF) relies on serial biomarker measures of myocardial stress or self-reported symptom resolution to determine treatment effectiveness. Despite this, many patients leave the hospital with residual congestion - a circumstance associated with worse outcomes. An affordable, objective, non-invasive method of gauging the response to treatment, particularly at the myocardial level, could have significant impact on outcomes such as hospital length of stay and post-discharge readmission. We developed a novel, accelerometer-based acoustic cardiography device for such a purpose and designed this pilot study to examine differences in acquired signals from patients treated for AHF in the emergency department (ED) compared with signals from age and sex matched controls. Patients 18 years of age with AHF (n=20) diagnosed by an emergency physician were eligible for inclusion. Age- and sex-matched controls (n=20) without a history of cardiovascular disease and no clinical suspicion of an acute cardiovascular disorder were also enrolled. While in the ED, leads were applied directly to the chest in standard auscultation positions for both groups. Recordings proceeded for up to 3 hours concurrent with treatment for AHF patients and up to 30 minutes for controls. A follow-up recording was made prior to discharge for AHF patients. Recordings were evaluated across the range of acquired signals to identify patterns suggestive of AHF and of those possibly attributable to reduction in acute myocardial strain. For the purpose of simplifying interpretation and establishing a single value scoring system, the ratio of signal intensity within a 4-20 Hz range of interest to total signal intensity (aka, “power ratio” [PR]) was calculated (Figure). Normal PR was established based on control patient data, and AHF patients were subgrouped based on PR trends over time. Of the enrolled patients, 13 (65%) controls and 11 (55%) AHF patients had recordings with useable data. Mean PR score in the control group (mean age 43, 65% male) was 56.1% (range: 23.1-81.7%). Mean initial PR score in the AHF group (mean age 58, 80% male) was 44% (range: 16-77%) and post-treatment was 49% (range: 25-80%). Among the AHF patients, 4 subgroups were noted (Table): group 1 (n=3) had initial PR scores >50% that trended toward 50% with time; group 2 (n=4) had initial PR scores <50% that trended toward 50% with time; group 3 (n=3) had PR scores that remaining above (n=1) or below (n=2) 50%; and group 4 (n=1) had an initial PR score of 55%. As shown in the Table, distinct differences in baseline cardiac function exist within these subgroups. Using a novel, accelerometer-based acoustic cardiography device, we identified the power ratio as a potential measure of myocardial stress. Data on PR in AHF patients, and age- and sex-matched controls suggest that distinct acoustic patterns exist and that changes in these patterns over time reflect differences in baseline cardiac function, response to treatment, or both. Further hardware and software development is underway, and additional human studies are planned.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
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• W2530548590 date "2016-10-01" @default.
• W2530548590 modified "2023-09-26" @default.
• W2530548590 title "46EMF Accelerometer-based Acoustic Cardiography to Detect Ventricular Unloading in Acute Heart Failure" @default.
• W2530548590 doi "https://doi.org/10.1016/j.annemergmed.2016.08.056" @default.
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