Department of Emergency Medicine, Beijing Shijitan Hospital, Beijing 100038, China.
Chin Med J (Engl). 2010 May 5;123(9):1127-32.
Although acute congestive heart failure (CHF) patients typically present with abnormal auscultatory findings on lung examination, lung sounds are not normally subjected to rigorous analysis. The goals of this study were to use a computerized analytic acoustic tool to evaluate lung sound patterns in CHF patients during acute exacerbation and after clinical improvement and to compare CHF profiles with those of normal individuals.
Lung sounds throughout the respiratory cycle was captured using a computerized acoustic-based imaging technique. Thirty-two consecutive CHF patients were imaged at the time of presentation to the emergency department and after clinical improvement. Digital images were created, geographical area of the images and lung sound patterns were quantitatively analyzed.
The geographical areas of the vibration energy image of acute CHF patients without and with radiographically evident pulmonary edema were (67.9 +/- 4.7) and (60.3 +/- 3.5) kilo-pixels, respectively (P < 0.05). In CHF patients without and with radiographically evident pulmonary edema (REPE), after clinical improvement the geographical area of vibration energy image of lung sound increased to (74.5 +/- 4.4) and (73.9 +/- 3.9) kilo-pixels (P < 0.05), respectively. Vibration energy decreased in CHF patients with REPE following clinical improvement by an average of (85 +/- 19)% (P < 0.01).
With clinical improvement of acute CHF exacerbations, there was more homogenous distribution of lung vibration energy, as demonstrated by the increased geographical area of the vibration energy image. Lung sound analysis may be useful to track in acute CHF exacerbations.
尽管急性充血性心力衰竭(CHF)患者通常在肺部检查时出现异常听诊结果,但肺部声音通常不会进行严格的分析。本研究的目的是使用计算机分析声学工具评估急性加重期和临床改善后 CHF 患者的肺部声音模式,并将 CHF 特征与正常个体进行比较。
使用基于计算机的声学成像技术捕获整个呼吸周期的肺部声音。对 32 例连续的 CHF 患者在急诊科就诊时和临床改善后进行成像。创建数字图像,对图像的地理区域和肺部声音模式进行定量分析。
无放射影像学肺水肿和有放射影像学肺水肿的急性 CHF 患者的振动能量图像的地理区域分别为(67.9 ± 4.7)和(60.3 ± 3.5)千像素(P < 0.05)。在无放射影像学肺水肿和有放射影像学肺水肿的 CHF 患者(REPE)中,临床改善后肺部声音的振动能量图像的地理区域分别增加到(74.5 ± 4.4)和(73.9 ± 3.9)千像素(P < 0.05)。在临床改善后,REPE 的 CHF 患者的振动能量平均减少了(85 ± 19)%(P < 0.01)。
随着急性 CHF 恶化的临床改善,肺部振动能量的分布更加均匀,这表现为振动能量图像的地理区域增加。肺部声音分析可能有助于监测急性 CHF 恶化。