For this reason we employed a porcine model of permanent acute coronary occlusion, and evaluated a possible correlation between parameters obtained by AC and the ones obtained with a reliable yet invasive technique, pressure-volume (PV) assessment. In the specific setting of acute coronary syndrome, AC might play a role in patient management by detecting cardiac dysfunction ( Marcus et al., 2005) in a prompt and accurate manner. Such a hybrid technique, acoustic cardiography (AC) ( Erne, 2008), has been proven as a reliable method for patient stratification and prognosis in diverse pathological conditions. Nevertheless, by coupling heart sound recordings together with ECG tracings, investigators can acquire important insights regarding the electrical-mechanical activity of the heart in an unsupervised, non-invasive and inexpensive manner. In fact, findings obtained from acoustic examination can be affected by operator’s expertise, limited sensitivity of the human ear and lack of reproducibility. Despite technical refinements, knowledge advancements and limited costs, auscultation has lost momentum over time in favor of less operator-dependent techniques. These findings should propel interest in resurrecting this technique for future translational studies as well as reconsidering its reintroduction in the clinical setting.Ĭardiac auscultation has been a pivotal part of patients’ examination since the stethoscope invention in 1816 by the French physician René Laennec. 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).Ĭonclusion: In the rapidly evolving setting of acute myocardial ischemia, acoustic cardiography provided meaningful insights of mechanical dysfunction in a prompt and non-invasive manner. 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. Indexes of systolic and diastolic impairment correlated with quantifiable features of heart sounds. Similar systolic and diastolic intervals obtained with the two techniques were significantly correlated. Pressure-volume analysis was conducted in parallel as an invasive method of hemodynamic assessment for comparison. Acoustic cardiography analyses were performed prior, during and after coronary occlusion. Methods and Results: Ten female Swiss large white pigs underwent permanent distal coronary occlusion as a model of acute myocardial ischemia. 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. 5Department of Cardiology, University Hospital Zurich, Zurich, Switzerlandīackground: 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.4Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.3VisCardia, Inc., Portland, OR, United States.2Division of Surgical Research, University Hospital Zurich, Zurich, Switzerland.1Department of Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland.Marco Luciani 1*, Matteo Saccocci 1, Shingo Kuwata 1, Nikola Cesarovic 2, Miriam Lipiski 2, Patricia Arand 3, Peter Bauer 3, Andrea Guidotti 1, Evelyn Regar 1, Paul Erne 4, Michel Zuber 5 and Francesco Maisano 1
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