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Lehmacher, Jonas; Neumann, Johannes T; Sörensen, Nils Arne; Goßling, Alina; Schmidt, Samuel Emil; Zeller, Tanja; Blankenberg, Stefan; Westermann, Dirk; Clemmensen, Peter M

Diagnostic performance of a device for acoustic heart sound analysis in patients with suspected myocardial infarction

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  • Medientyp: E-Artikel
  • Titel: Diagnostic performance of a device for acoustic heart sound analysis in patients with suspected myocardial infarction
  • Beteiligte: Lehmacher, Jonas; Neumann, Johannes T; Sörensen, Nils Arne; Goßling, Alina; Schmidt, Samuel Emil; Zeller, Tanja; Blankenberg, Stefan; Westermann, Dirk; Clemmensen, Peter M
  • Erschienen: BMJ, 2023
  • Erschienen in: Open Heart, 10 (2023) 1, Seite e002090
  • Sprache: Englisch
  • DOI: 10.1136/openhrt-2022-002090
  • ISSN: 2053-3624
  • Schlagwörter: Cardiology and Cardiovascular Medicine
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:sec><jats:title>Background</jats:title><jats:p>As only a small proportion of patients with chest pain suffers from myocardial infarction (MI), safe rule-out of MI is of immense importance. Recently an ultrasensitive microphone performing diastolic heart sound analysis (CADScorSystem) for rule-out of coronary artery disease (CAD) has emerged. In this explorational study, we aimed to evaluate the feasibility of the CADScorSystem for diagnosis of MI in the setting of a large emergency department.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Patients presenting to the emergency department with suspected MI were included. Acoustic heart sound analysis was performed in all patients and automated CAD-score values were calculated via a device-embedded algorithm, which also requires inclusion of three clinical variables: age, sex and presence of hypertension. Patients additionally received serial high-sensitive troponin T measurement measurements to assess the final diagnosis according to third Universal Definition of Myocardial Infarction applying the European Society of Cardiology 0 hour/3 hours algorithm. Diagnostic parameters for MI, considering different CAD-score cut-offs, were computed.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of 167 patients, CAD-scores were available in 61.1%. A total of eight patients were diagnosed with MI. At a cut-off value of &lt;20, CAD-score had a negative predictive value (NPV) of 90.7 (78.4–96.3). The corresponding positive predictive value (PPV) was 6.8 (2.7–16.2). For the adjusted CAD-score (age, sex, hypertension), at a cut-off value of &lt;20, NPV was 90.0 (59.6–99.5) with a PPV of 10.8 (5.3–20.6).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>In this explorative analysis, a transcutaneous ultrasensitive microphone for heart sound analysis resulted in a high NPV analogous to the findings in rule-out of stable CAD in elective patients yet inferior to serial high-sensitivity cardiac troponin measurements and does not seem feasible for application in an emergency setting for rule-out of MI.</jats:p></jats:sec><jats:sec><jats:title>Trial registration number</jats:title><jats:p><jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="clintrialgov" xlink:href="NCT02355457">NCT02355457</jats:ext-link>.</jats:p></jats:sec>
  • Zugangsstatus: Freier Zugang