School of Biomedical Engineering, Dalian University of Technology.
Int Heart J. 2022;63(3):612-622. doi: 10.1536/ihj.21-676.
Acoustic cardiography (AC) combined with heart sound (HS) recording and electrocardiogram (ECG) provides a noninvasive and inexpensive way to understand the electrical mechanical activity of the heart. Pulmonary artery stenosis can cause hemodynamic abnormalities that might lead to pulmonary hypertension (PH). In this paper, we examined the relationships between the acoustic characteristics of the AC and hemodynamic changes in a beagle dog model of PH.Four healthy beagle dogs were injected with the prostaglandin endoperoxide receptor agonist U-44069 to induce acute PH states. AC was employed to analyze the process of pre-PH, intra-PH, and post-PH. Right ventricular blood pressure (RVBP) was measured via right cardiac catheterization, an invasive method performed in parallel for comparative hemodynamic evaluation. As RVBP increased or decreased, the HS features changed accordingly during acute PH occurrence and development. Right ventricular systolic blood pressure (RVSBP) significantly correlated with the minimum of the first HS (S1) amplitude (correlation coefficient (CC) = -0.82), energy of the S1 (CC = 0.86), energy of the second HS (S2) (CC = 0.67), entropy of the S1 (CC = -0.94), and ratio of electromechanical systolic time (EMST) to the cardiac cycle time (CC = 0.81). The two techniques (AC [HSs and ECG] versus right cardiac catheterization [RVBP]) were significantly correlated. Especially, the diastolic filling time (DFT) had a significant relationship with the right ventricular diastolic time (RVDT) (CC = 0.97), perfusion time (PT) (CC = 0.96), and cardiac cycle time (RR) (CC = 0.96). The CCs between the RVDT and the max dp/dt to min dp/dt, the EMST and the Q to min dp/dt, and the electromechanical activation time and the Q to max dp/dt were 0.95, 0.99, and 0.86, respectively. Furthermore, the logistic regression model with different combinations was used to identify the effective features for monitoring hemodynamic and pathophysiologic conditions.AC provided significant insight into mechanical dysfunction in a rapid and noninvasive way that could be used for early screening of PH.
声学心动图（AC）结合心音（HS）记录和心电图（ECG）提供了一种非侵入性和廉价的方法来了解心脏的电机械活动。肺动脉狭窄可导致血流动力学异常，可能导致肺动脉高压（PH）。在本文中，我们研究了犬 PH 模型中 AC 的声学特征与血流动力学变化之间的关系。
将前列腺素内过氧化物受体激动剂 U-44069 注射到 4 只健康比格犬中，以诱导急性 PH 状态。使用 AC 分析 PH 前、PH 中和 PH 后过程。通过右心导管术测量右心室血压（RVBP），这是一种并行进行的侵入性方法，用于比较血流动力学评估。随着 RVBP 的升高或降低，在急性 PH 发生和发展过程中心音特征相应变化。右心室收缩压（RVSBP）与第一心音（S1）幅度的最小值（相关系数（CC）=-0.82）、S1 能量（CC=0.86）、第二心音（S2）能量（CC=0.67）、S1 熵（CC=-0.94）和机电收缩时间（EMST）与心动周期时间（CC=0.81）之比显著相关。两种技术（AC[HS 和 ECG]与右心导管术[RVBP]）显著相关。特别是，舒张充盈时间（DFT）与右心室舒张时间（RVDT）（CC=0.97）、灌注时间（PT）（CC=0.96）和心动周期时间（RR）（CC=0.96）有显著关系。RVDT 与最大 dp/dt 至最小 dp/dt、EMST 与 Q 至最小 dp/dt 以及机电激活时间与 Q 至最大 dp/dt 的 CC 分别为 0.95、0.99 和 0.86。此外，使用不同组合的逻辑回归模型来识别用于监测血流动力学和病理生理状况的有效特征。
AC 以快速和非侵入性的方式提供了对机械功能障碍的重要见解，可用于 PH 的早期筛查。
