Performance of Phonoelectrocardiographic Left Ventricular Systolic Time Intervals and B‐Type Natriuretic Peptide Levels in the Diagnosis of Left Ventricular Dysfunction
Key result
Phonoelectrocardiographic measurement of an abnormal electromechanical activation time (EMAT) ≥15 was significantly associated with left ventricular dysfunction (OR 1.38) independent of BNP levels.
Why the study?
Does computerized phonoelectrocardiographic analysis combined with BNP testing accurately diagnose left ventricular dysfunction in adult patients undergoing left heart catheterization?
Population
100 adult patients undergoing left heart catheterization
Comparison
Computerized phonoelectrocardiographic analysis… vs Left ventricular dysfunction defined as the…
Design
Cross-sectional
Authors
Discussion
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Implication
May support adjunctive EMAT assessment with BNP for LV dysfunction; leaves open prospective validation before clinical adoption.
Study Design
Type
Cross-Sectional (n=100)
Multicenter
No
Structured PICO
Does computerized phonoelectrocardiographic analysis combined with BNP testing accurately diagnose left ventricular dysfunction in adult patients undergoing left heart catheterization?
P
Population
100 adult patients undergoing left heart catheterization
I
Intervention
Computerized phonoelectrocardiographic analysis (measuring electromechanical activation time [EMAT], electromechanical systole [Q-S2], and left ventricular systolic time [LVST]) and B-type natriuretic peptide (BNP) testing
C
Comparator
Left ventricular dysfunction defined as the presence of both LVEDP >15 mmHg and LVEF <50% (measured by left heart catheterization and transthoracic echocardiography)
O
Outcome
Diagnostic performance (sensitivity, specificity, likelihood ratio) for detecting left ventricular dysfunctionsurrogate
Main Result
Effect estimate: OR 1.38 (95% CI 1.13-1.69)
p-value: p=<0.0001
Phonoelectrocardiographic measures of systolic time intervals are highly specific for detecting left ventricular dysfunction and provide diagnostic information independent of BNP.
Limitations
- Small sample size
- Diagnostic accuracy within different ranges of BNP results requires confirmation with a larger sample
- Cutoffs for EMAT and EMAT/LVST were chosen retrospectively after inspection of the ROC curves
- Absence of carotid pressure tracing analysis
Cite This Study
Moyers et al. (2007) conducted a cross-sectional in Left Ventricular Dysfunction (n=100). Phonoelectrocardiographic systolic time intervals (EMAT) vs. B-type natriuretic peptide (BNP) was evaluated on Diagnosis of left ventricular dysfunction (LVEDP > 15 mmHg and LVEF < 50%) using EMAT ≥15 (OR 1.38, 95% CI 1.13-1.69, p=<0.0001). Phonoelectrocardiographic measurement of an abnormal electromechanical activation time (EMAT) ≥15 was significantly associated with left ventricular dysfunction (OR 1.38) independent of BNP levels.