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Ballistocardiography to identify high left atrial pressure in patients with heart failure
Li Zhang1, Peiwei Cai2, Yinlong Deng3
1Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou, China; Clinical Research Center, the First Affiliated Hospital of Shantou University Medical College, Shantou, China.
Insights
A novel non-invasive ballistocardiography (BCG) method accurately predicts elevated left atrial pressure (LAP) in heart failure (HF) patients. This early detection using the BCG-B3 index aids in timely diagnosis and treatment, improving patient outcomes.
Area of Science:
- Cardiology
- Biomedical Engineering
- Diagnostic Technology
Background:
- Heart failure (HF) presents a significant global health burden due to high prevalence and morbidity.
- Elevated left atrial pressure (LAP) is an early indicator of HF symptoms.
- Non-invasive methods for early LAP detection are crucial for timely HF management.
Purpose of the Study:
- To evaluate the predictive value of a novel non-invasive ballistocardiography (BCG) method for assessing LAP in HF patients.
- To determine the diagnostic efficacy of the BCG-B3 index, representing early diastolic ventricular vibration waves, for elevated LAP.
Main Methods:
- Prospective enrollment of 83 HF patients and 20 controls.
- Collection of cross-sectional ballistocardiography (BCG) and echocardiography (ECHO) data.
- Estimation of LAP using E/e' ratio or Nagueh equation; ROC curve analysis for BCG-B3 index efficacy.
Main Results:
- A significant correlation was found between the BCG-B3 index and the E/e' ratio (r=0.51, P<0.01).
- The BCG-B3 index demonstrated high accuracy in identifying elevated LAP, with an overall consistency value of 0.82 at an optimal cutoff of 55.13.
- Positive and negative consistency values were 0.93 and 0.53, respectively.
Conclusions:
- The non-invasive BCG-B3 index is a valuable tool for accurately identifying elevated LAP in HF patients.
- BCG offers a portable and experience-independent method for timely HF patient assessment.
- This technology facilitates early diagnosis and treatment initiation for heart failure.
Background:
Due to a high prevalence and morbidity rate, heart failure (HF) constitutes an immense economic burden on the global health care system. An increase in left atrial pressure (LAP) precedes the occurrence of any HF symptoms. In this study, we applied a novel non-invasive method of ballistocardiography (BCG) to extract early diastolic ventricular vibration waves [the BCG-B3 index, which corresponds to the third heart sound (S3) at the end of the rapid filling phase of diastole]. This study evaluated the predictive value of the BCG-B3 index for LAP in HF patients.
Methods:
A total of 83 HF patients and 20 patients with underlying diseases were prospectively enrolled, and their cross-sectional BCG and echocardiography (ECHO) data were collected. BCG obtains a signal through a high-precision fiber-optic sensor placed on the patient's back. LAP or pulmonary capillary wedge pressure (PCWP) was estimated by the ratio of mitral inflow peak early diastolic velocity to the early diastolic velocity of the mitral annulus (E/e') or the Nagueh equation (LAP = 1.24 × E/e' + 1.9). To evaluate the diagnostic efficacy of the BCG-B3 index, a receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUC) was calculated. The best cutoff value for the BCG-B3 index was determined by the maximum Youden index.
Results:
The correlation coefficient between the BCG-B3 index and E/e' ratio was 0.51 (P<0.01). Under an optimal cutoff value of 55.13, the BCG-B3 index showed a positive consistency value of 0.93, a negative consistency value of 0.53, and an overall consistency value of 0.82 for identification of significantly elevated LAP.
Conclusions:
The BCG-B3 index derived by noninvasive BCG using a built-in fiber-optic sensor has important diagnostic value for identifying significantly elevated LAP in HF patients with high accuracy. BCG examination is not limited by place or the doctor's experience. Therefore, BCG can provide timely assessments for HF patients, enabling early diagnosis and treatment.
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