Department of Veterinary Sciences, University of Pisa, Pisa, Italy.
Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy.
Vet Res Commun. 2024 Nov 27;49(1):43. doi: 10.1007/s11259-024-10584-w.
Smartphone-based technology is increasingly used in veterinary medicine as a complementary tool for cardiac auscultation and ECG recording. This prospective observational study evaluates a digital stethoscope (DS) that consists of simultaneous phonocardiographic and one-lead ECG recording (dECG) in adult horses, comparing it with auscultation using a conventional stethoscope (CS) and reference base-apex ECG (rECG). A total of 104 horses underwent cardiac auscultation using CSs and DSs to detect arrhythmias and murmurs. Audio and dECG were acquired using the DS. The rECG tracings were also recorded. All ECG tracings were blindly evaluated for interpretability, measurements, and diagnosis. The Shapiro-Wilk test was used to assess the data distribution. Weighted Cohen's κ and Bland Altman plot analysis were applied to verify the agreement between reference vs. smartphone-based methods. Almost perfect agreement was found in detecting murmurs and/or arrhythmias between auscultation with the CS and DS, and between CS auscultation and re-listening to DS audio. Perfect agreement was observed between re-listening to DS audio and DS auscultation and in detecting murmur timing between CS and DS auscultation. Almost perfect agreement was found between rECG and dECG in detecting bradycardia, tachycardia, or normal heart rate (HR) and for P-wave polarity. The lack of variability with both methods for QRS polarity prevented statistical analyses from being performed. Fair agreement was found in the assessment of the presence of artifact. In conclusion, the DS reliably detected heart murmurs and arrhythmias through direct auscultation and re-listening to recordings, and accurately evaluated HR, wave and interval measurements, P-wave and QRS-complex polarities in adult horses.
基于智能手机的技术越来越多地被应用于兽医领域，作为心脏听诊和心电图记录的辅助工具。本前瞻性观察研究评估了一种数字听诊器（DS），它可以同时记录心音和单导联心电图（dECG），并将其与传统听诊器（CS）和参考心尖-心底心电图（rECG）进行比较。共有 104 匹马接受了 CS 和 DS 的心脏听诊，以检测心律失常和杂音。使用 DS 采集音频和 dECG。还记录了 rECG 轨迹。所有 ECG 轨迹均进行盲法评估，以评估可解释性、测量值和诊断。Shapiro-Wilk 检验用于评估数据分布。应用加权 Cohen's κ 和 Bland Altman 图分析来验证参考与基于智能手机的方法之间的一致性。在检测 CS 和 DS 听诊时的杂音和/或心律失常、CS 听诊与重新听取 DS 音频之间，以及 CS 和 DS 听诊之间的杂音时间方面，发现了几乎完美的一致性。在重新听取 DS 音频和 DS 听诊之间，以及在检测 CS 和 DS 听诊之间的心动过缓、心动过速或正常心率（HR）和 P 波极性方面，发现了完美的一致性。rECG 和 dECG 在检测心动过缓、心动过速或正常心率（HR）和 P 波极性方面几乎完全一致。两种方法的 QRS 极性变化不大，因此无法进行统计分析。在评估存在伪影方面，发现了良好的一致性。总之，DS 通过直接听诊和重新听取录音可靠地检测到心脏杂音和心律失常，并准确评估了 HR、波和间期测量值、成年马的 P 波和 QRS 复合体极性。
