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Advanced heart sound analysis as a new prognostic marker in stable coronary artery disease

Simon Winther1, Louise Nissen1, Samuel Emil Schmidt2

  • 1Department of Cardiology, Gødstrup Hospital, Hospitalsparken 15, 7400 Herning, Denmark.

European Heart Journal. Digital Health
|January 30, 2023
PubMed

Insights

Heart sound analysis shows prognostic value for coronary artery disease (CAD). The Acoustic-score and CAD-score can help stratify risk in patients with suspected CAD, improving patient outcomes.

Area of Science:

  • Cardiology
  • Medical Diagnostics
  • Biomedical Engineering

Background:

  • Obstructive coronary artery disease (CAD) diagnosis is improving with heart sound analysis.
  • The prognostic impact of heart sound analysis for CAD requires further investigation.
  • Current risk stratification for suspected CAD may be enhanced by novel diagnostic tools.

Purpose of the Study:

  • To evaluate the prognostic value of heart sound analysis using the Acoustic-score and CAD-score.
  • To assess the utility of these scores in patients with suspected CAD managed under standard care.
  • To determine if heart sound analysis can improve initial risk stratification for CAD.

Main Methods:

  • Consecutive patients with angina symptoms referred for coronary computed tomography angiography (CTA) were enrolled.
  • The Acoustic-score was derived from eight acoustic CAD-related features.
  • The CAD-score integrated the Acoustic-score with patient risk factors. A threshold of >20 was used for both scores to indicate disease.
  • Follow-up for the primary endpoint (all-cause mortality and myocardial infarction) was 3.1 years.

Main Results:

  • The study included 1464 patients; 26 experienced primary endpoints.
  • Patients with primary endpoints had high scores: Acoustic-score >20 in 96% and CAD-score >20 in 85%.
  • Scores >20 were associated with significantly increased risk (HR 12.6 for Acoustic-score, 5.4 for CAD-score).
  • The CAD-score provided prognostic information independent of lipid-lowering therapy, CTA stenosis, and early revascularization.

Conclusions:

  • Heart sound analysis, through the Acoustic-score and CAD-score, demonstrates prognostic capability in suspected CAD.
  • These scores may enhance the initial risk stratification of patients with suspected coronary artery disease.
  • Further research into heart sound analysis could refine diagnostic and prognostic strategies for CAD.
Abstract

Keywords:
Acoustic cardiographyCardiovascular diagnostic techniqueCoronary stenosisHeart soundPrognosis

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