Audible Coronary Artery Stenosis

Area of Science:

• Cardiovascular Medicine
• Biomedical Engineering
• Diagnostic Imaging

Background:

• Hemodynamically significant coronary artery stenoses cause turbulent blood flow, leading to audible intracoronary murmurs.
• Coronary angiography is the gold standard for diagnosing coronary artery stenosis but is invasive.

Purpose of the Study:

• To evaluate the performance of modern acoustic detection of intracoronary murmurs.
• To assess the accuracy of acoustic signals in identifying coronary artery stenoses compared to coronary angiography.

Main Methods:

• Prospective study of 156 patients undergoing elective coronary angiography.
• Acoustic signals were captured pre-angiography and analyzed blinded to clinical and angiographic data.
• Stenosis severity was graded by angiography, blinded to acoustic findings.

Main Results:

• Acoustic detection showed a sensitivity of 0.70 and specificity of 0.80 for stenosis ≥50% in any vessel.
• For stenosis ≥50% in major vessels, sensitivity was 0.72 and specificity was 0.76.
• The area under the curve for acoustic detection was 0.75 for any stenosis and 0.76 for major vessel stenosis.

Conclusions:

• Modern acoustic analysis can identify intracoronary murmurs from significant coronary artery stenoses.
• This non-invasive acoustic modality shows potential for diagnosing obstructive coronary artery disease.
• Further research is needed to compare its clinical performance with existing noninvasive methods.