Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou, China; Clinical Research Center, the First Affiliated Hospital of Shantou University Medical College, Shantou, China.
Ultrasound Division, the First Affiliated Hospital of Shantou University Medical College, Shantou, China.
Ann Palliat Med. 2021 Jul;10(7):8155-8168. doi: 10.21037/apm-21-1840.
Due to a high prevalence and morbidity rate, heart failure (HF) constitutes an immense economic burden on the global health care system. An increase in left atrial pressure (LAP) precedes the occurrence of any HF symptoms. In this study, we applied a novel non-invasive method of ballistocardiography (BCG) to extract early diastolic ventricular vibration waves [the BCG-B3 index, which corresponds to the third heart sound (S3) at the end of the rapid filling phase of diastole]. This study evaluated the predictive value of the BCG-B3 index for LAP in HF patients.
A total of 83 HF patients and 20 patients with underlying diseases were prospectively enrolled, and their cross-sectional BCG and echocardiography (ECHO) data were collected. BCG obtains a signal through a high-precision fiber-optic sensor placed on the patient's back. LAP or pulmonary capillary wedge pressure (PCWP) was estimated by the ratio of mitral inflow peak early diastolic velocity to the early diastolic velocity of the mitral annulus (E/e') or the Nagueh equation (LAP = 1.24 × E/e' + 1.9). To evaluate the diagnostic efficacy of the BCG-B3 index, a receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUC) was calculated. The best cutoff value for the BCG-B3 index was determined by the maximum Youden index.
The correlation coefficient between the BCG-B3 index and E/e' ratio was 0.51 (P<0.01). Under an optimal cutoff value of 55.13, the BCG-B3 index showed a positive consistency value of 0.93, a negative consistency value of 0.53, and an overall consistency value of 0.82 for identification of significantly elevated LAP.
The BCG-B3 index derived by noninvasive BCG using a built-in fiber-optic sensor has important diagnostic value for identifying significantly elevated LAP in HF patients with high accuracy. BCG examination is not limited by place or the doctor's experience. Therefore, BCG can provide timely assessments for HF patients, enabling early diagnosis and treatment.
心力衰竭（HF）的患病率和发病率都很高，因此给全球的医疗保健系统带来了巨大的经济负担。左心房压（LAP）升高先于 HF 症状的出现。在这项研究中，我们应用了一种新的非侵入性的振动心音图（BCG）方法来提取早期舒张期心室振动波[BCG-B3 指数，与舒张早期快速充盈期结束时的第三心音（S3）相对应]。本研究评估了 BCG-B3 指数对 HF 患者 LAP 的预测价值。
前瞻性纳入 83 例 HF 患者和 20 例基础疾病患者，收集其横断面 BCG 和超声心动图（ECHO）数据。BCG 通过放置在患者背部的高精度光纤传感器获取信号。LAP 或肺毛细血管楔压（PCWP）通过二尖瓣流入峰早期舒张速度与二尖瓣环早期舒张速度的比值（E/e'）或 Nagueh 方程（LAP=1.24×E/e'+1.9）来估计。为了评估 BCG-B3 指数的诊断效能，绘制了受试者工作特征（ROC）曲线，并计算了 ROC 曲线下的面积（AUC）。通过最大 Youden 指数确定 BCG-B3 指数的最佳截断值。
BCG-B3 指数与 E/e'比值的相关系数为 0.51（P<0.01）。在最佳截断值为 55.13 时，BCG-B3 指数对显著升高的 LAP 的阳性一致性值为 0.93，阴性一致性值为 0.53，总一致性值为 0.82。
使用内置光纤传感器的非侵入性 BCG 得出的 BCG-B3 指数对识别 HF 患者显著升高的 LAP 具有重要的诊断价值，准确性高。BCG 检查不受地点或医生经验的限制。因此，BCG 可以为 HF 患者提供及时的评估，从而实现早期诊断和治疗。
