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Published on: May 31, 2022
Digitized Acoustic Analysis for Monitoring Hemodialysis Access Dysfunction: Insights from Vascular Imaging and
Hsien-Yuan Chang1,2, Yi-Ling Kuo1, Christian Deantana3
1Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
Insights
Digitized acoustic data effectively detects hemodialysis access dysfunction in arteriovenous fistulas (AVF). This non-invasive method shows promise for monitoring vascular access health and guiding interventions.
Area of Science:
- Nephrology
- Biomedical Engineering
- Medical Acoustics
Background:
- Hemodialysis access dysfunction leads to missed treatments and mortality.
- Current monitoring methods like physical exams and ultrasound have limitations.
- A need exists for more efficient and accurate vascular access monitoring.
Purpose of the Study:
- To investigate the utility of digitized acoustic data for identifying and monitoring hemodialysis access dysfunction.
- To compare acoustic findings in arteriovenous fistulas (AVF) and arteriovenous grafts (AVG).
- To assess acoustic changes before and after angioplasty interventions.
Main Methods:
- Prospective study of 157 hemodialysis patients (AVF/AVG) from June 2023 to February 2025.
- Vascular imaging (angiography/ultrasound) confirmed stenosis.
- Standardized acoustic data recording and analysis (loudness, peak-to-valley, frequency distribution).
Main Results:
- Significant acoustic differences detected in AVF arterial puncture and anastomosis sites with dysfunction.
- Venous site dysfunction in AVFs showed reduced sound volume and increased peak-to-valley ratio.
- Acoustic data normalized post-angioplasty in AVFs; no significant changes observed in AVGs.
Conclusions:
- Digitized acoustic analysis is effective for detecting and monitoring AVF dysfunction.
- Acoustic data shows potential for clinical integration, especially with AI models.
- Further research may enhance diagnostic capabilities for hemodialysis access monitoring.
Abstract:
Background: Hemodialysis access dysfunction can lead to missed treatments and increased mortality. Traditional monitoring methods, such as physical examination and ultrasound, have limitations, emphasizing the need for a more efficient approach. This study investigates the use of digitized acoustic data to identify and monitor vascular access dysfunction. Methods: This prospective study involved patients undergoing hemodialysis with either arteriovenous fistulas (AVF) or arteriovenous grafts (AVG) between June 2023 and February 2025. All patients underwent vascular imaging (either angiography or ultrasound) to confirm the degree of stenosis. Acoustic data were recorded using a standardized procedure at various puncture sites. Pre- and post-angioplasty data were also collected to assess the effects of vascular intervention. The digitized acoustic data were analyzed for changes in relative loudness, peak-to-valley ratios, and frequency distribution. Results: A total of 157 patients with 236 audio recordings (mean age: 67 ± 11 years; 58% male) were included. Significant acoustic differences were found at the arterial puncture and anastomosis sites in AVF patients with dysfunction, particularly in venous site dysfunction, which exhibited a more pronounced reduction in sound volume and an increased peak-to-valley ratio. After angioplasty, acoustic changes were observed in both arterial and venous sites, with values moving toward normal levels. However, no significant acoustic changes were observed in AVG patients. Additionally, frequency distribution ratios showed minimal clinical relevance. Conclusions: Digitized acoustic data, particularly from the arterial puncture and anastomosis sites, can be an effective tool for detecting and monitoring hemodialysis access dysfunction. These findings suggest potential for acoustic analysis in clinical practice, especially when integrated with AI models for better diagnostics.
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