Kosmicki Douglas L, Collins Sean P, Kontos Michael C, Zuber Michel, Kipfer Peter, Attenhofer Jost Christine, Michaels Andrew D
Division of Cardiology, University of Utah, Salt Lake City, UT 84132-2401, USA.
Congest Heart Fail. 2010 Nov-Dec;16(6):249-53. doi: 10.1111/j.1751-7133.2010.00191.x. Epub 2010 Oct 21.
The signs and symptoms of systolic heart failure are frequently insensitive and nonspecific, making an accurate bedside diagnosis of left ventricular systolic dysfunction (LVSD) challenging. B-type natriuretic peptide (BNP) is often used, but is not diagnostically useful when in the indeterminate range. The authors investigated the diagnostic test characteristics of acoustic cardiographic parameters to identify patients with LVSD. Four hundred thirty-three patients with contemporaneous measurements of computerized acoustic cardiography, BNP, and echocardiography were included. The acoustic cardiographic model outperformed BNP alone at detecting reduced left ventricular ejection fraction (C statistic, 0.88 vs 0.67; P<.0001). The acoustic model with BNP did not perform better than the acoustic model alone (P=.14). Within the indeterminate BNP range, the acoustic model outperformed BNP (C statistic, 0.89 vs 0.64; P<.0001). Noninvasive computerized acoustic cardiography predicted LVSD in a diverse population. This acoustic cardiographic model outperformed BNP alone for predicting LVSD.
收缩性心力衰竭的体征和症状常常不敏感且不具特异性，这使得在床边准确诊断左心室收缩功能障碍（LVSD）颇具挑战性。B型利钠肽（BNP）常被使用，但处于不确定范围时对诊断并无帮助。作者研究了心音图参数用于识别LVSD患者的诊断测试特征。纳入了433例同时进行计算机化心音图、BNP及超声心动图测量的患者。在心音图模型检测左心室射血分数降低方面，其表现优于单独使用BNP（C统计量，0.88对0.67；P<0.0001）。联合BNP的声学模型并不比单独的声学模型表现更好（P = 0.14）。在BNP不确定范围内，声学模型优于BNP（C统计量，0.89对0.64；P<0.0001）。无创计算机化心音图可在不同人群中预测LVSD。该心音图模型在预测LVSD方面优于单独使用BNP。
