Reintroducing Heart Sounds for Early Detection of Acute Myocardial Ischemia in a Porcine Model – Correlation of Acoustic Cardiography With Gold Standard of Pressure-Volume Analysis
| العنوان: | Reintroducing Heart Sounds for Early Detection of Acute Myocardial Ischemia in a Porcine Model – Correlation of Acoustic Cardiography With Gold Standard of Pressure-Volume Analysis |
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| المؤلفون: | Francesco Maisano, Patricia Arand, Evelyn Regar, Paul Erne, Nikola Cesarovic, Peter T. Bauer, Michel Zuber, Marco Luciani, Shingo Kuwata, Andrea Guidotti, Matteo Saccocci, Miriam Lipiski |
| المساهمون: | University of Zurich, Luciani, Marco |
| المصدر: | Frontiers in Physiology Frontiers in Physiology, 10 Frontiers in Physiology, Vol 10 (2019) |
| بيانات النشر: | Frontiers Media S.A., 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | medicine.medical_specialty, Cardiac output, Fourth heart sound, Physiology, Diastole, Hemodynamics, 610 Medicine & health, 030204 cardiovascular system & hematology, hemodynamics, lcsh:Physiology, acute coronary syndrome, heart sound, 03 medical and health sciences, 0302 clinical medicine, 2737 Physiology (medical), Physiology (medical), Internal medicine, acute coronary syndrome acute myocardial ischemia animal model heart sound hemodynamics, Heart rate, Medicine, 030212 general & internal medicine, Third heart sound, Original Research, lcsh:QP1-981, business.industry, animal model, 1314 Physiology, medicine.disease, 10020 Clinic for Cardiac Surgery, Acute coronary syndrome, Acute myocardial ischemia, Heart sound, Animal model, Coronary occlusion, Heart sounds, Cardiology, medicine.symptom, business, acute myocardial ischemia |
| الوصف: | Background: Acoustic cardiography is a hybrid technique that couples heart sounds recording with ECG providing insights into electrical-mechanical activity of the heart in an unsupervised, non-invasive and inexpensive manner. During myocardial ischemia hemodynamic abnormalities appear in the first minutes and we hypothesize a putative diagnostic role of acoustic cardiography for prompt detection of cardiac dysfunction for future patient management improvement. Methods and Results: Ten female Swiss large white pigs underwent permanent distal coronary occlusion as a model of acute myocardial ischemia. Acoustic cardiography analyses were performed prior, during and after coronary occlusion. Pressure-volume analysis was conducted in parallel as an invasive method of hemodynamic assessment for comparison. Similar systolic and diastolic intervals obtained with the two techniques were significantly correlated [Q to min dP/dt vs. Q to second heart sound (r2 = 0.9583, p < 0.0001), PV diastolic filling time vs. AC perfusion time (r2 = 0.9686, p < 0.0001)]. Indexes of systolic and diastolic impairment correlated with quantifiable features of heart sounds [Tau vs. fourth heart sound Display Value (r2 = 0.2721, p < 0.0001) cardiac output vs. third heart sound Display Value (r2 = 0.0791 p = 0.0023)]. Additionally, acoustic cardiography diastolic time (AUC 0.675, p = 0.008), perfusion time (AUC 0.649, p = 0.024) and third heart sound Display Value (AUC 0.654, p = 0.019) emerged as possible indicators of coronary occlusion. Finally, these three parameters, when joined with heart rate into a composite joint-index, represent the best model in our experience for ischemia detection (AUC 0.770, p < 0.001). Conclusion: In the rapidly evolving setting of acute myocardial ischemia, acoustic cardiography provided meaningful insights of mechanical dysfunction in a prompt and non-invasive manner. These findings should propel interest in resurrecting this technique for future translational studies as well as reconsidering its reintroduction in the clinical setting. Frontiers in Physiology, 10 ISSN:1664-042X |
| وصف الملف: | fphys-10-01090.pdf - application/pdf; application/application/pdf |
| اللغة: | English |
| تدمد: | 1664-042X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b3a53dd6a7cb5d2da5dbdf9cf448bbf2 http://europepmc.org/articles/PMC6713932 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....b3a53dd6a7cb5d2da5dbdf9cf448bbf2 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1664042X |
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