Lin Chin-Yu, Chang Shih-Lin, Lin Yenn-Jiang, Lo Li-Wei, Hu Yu-Feng, Chao Tze-Fan, Chung Fa-Po, Tuan Ta-Chuan, Liao Jo-Nan, Chang Yao-Ting, Te Abigail Louise D, Yamada Shinya, Cheng Hao-Min, Sung Shih-Hsien, Kuo Ling, Li Hsing-Yuan, Chang Ting-Yung, Minh Hoang Quang, Salim Simon, Huang Ting-Chung, Chen Shih-Ann
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Institude of Clinical Medicine, Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Sci Rep. 2017 Nov 14;7(1):15490. doi: 10.1038/s41598-017-15573-5.
This study aimed to examine the relationship between measurements related to heart sounds and the origin of ventricular arrhythmia. We retrospectively evaluated 45 patients undergoing catheter ablation with contemporaneous digital acoustic cardiography of the first heart sound (S1) and the second heart sound (S2). The patients with baseline wide QRS morphology (>120 ms or aberrant conduction), heart failure, valvular heart disease, chronic pulmonary disease, and obesity were excluded. Ventricular arrhythmias from the left ventricle had an increased S1 complexity score and S1 duration in comparison to adjacent sinus beats. On the other hand, ventricular arrhythmia from right ventricle had decreased S1 complexity score and S1 duration in comparison to adjacent sinus beats. The difference of S1 (ΔS1) parameters between premature ventricular complex and sinus beat was significantly smaller in right ventricular arrhythmia group compared with and left ventricular arrhythmia group. For predicting the origin of ventricular arrhythmia, the ΔS1 duration provide better predictive accuracy (sensitivity: 100%, specificity: 100%, cutoff value: -1.28 ms) in comparison to ΔS1 complexity score (sensitivity 71.4%, specificity 75.0%, cutoff value: -0.13). The change of S1 complexity and duration determined from acoustic cardiography could accurately predict the ventricular arrhythmia origin.
本研究旨在探讨与心音相关的测量指标与室性心律失常起源之间的关系。我们回顾性评估了45例接受导管消融术的患者，同时对第一心音（S1）和第二心音（S2）进行数字心音图检查。排除基线QRS波形态增宽（>120 ms或存在异常传导）、心力衰竭、心脏瓣膜病、慢性肺部疾病和肥胖的患者。与相邻窦性搏动相比，左心室室性心律失常的S1复杂度评分和S1持续时间增加。另一方面，与相邻窦性搏动相比，右心室室性心律失常的S1复杂度评分和S1持续时间降低。与左心室心律失常组相比，右心室心律失常组室性早搏与窦性搏动之间的S1差异（ΔS1）参数明显更小。对于预测室性心律失常的起源，与ΔS1复杂度评分相比，ΔS1持续时间具有更好的预测准确性（敏感性：100%，特异性：100%，临界值：-1.28 ms）（敏感性71.4%，特异性75.0%，临界值：-0.13）。通过心音图确定的S1复杂度和持续时间的变化能够准确预测室性心律失常的起源。
