An Integrated Heart Sound-Electrocardiogram Synchronization System for Early Detecting Left Ventricular Systolic...

Area of Science:

• Cardiology
• Biomedical Engineering
• Pediatric Health

Background:

• Early detection of pediatric left ventricular systolic dysfunction (LVSD) is crucial but challenging, especially in resource-limited settings.
• A novel synchronized heart sound-electrocardiogram (HS-ECG) system offers a potential solution for diagnosing LVSD in underserved pediatric populations.

Purpose of the Study:

• To evaluate the efficacy of a novel synchronized HS-ECG system for detecting pediatric LVSD.
• To identify age-specific cardiac acoustic biomarkers (CABs) for early LVSD diagnosis in children.

Main Methods:

• A prospective cohort study included 212 children (3-16 years) with LVSD (n=80) and controls (n=132).
• Synchronized HS-ECG recordings were obtained using a wearable device, and signals were analyzed via wavelet analysis to derive CABs.
• Key biomarkers included electromechanical activation time (EMAT) and its rate-corrected value (EMATc), with echocardiographic LVEF as the reference standard.

Main Results:

• In younger children (3-6 years), rate-corrected electromechanical activation time (EMATc) strongly correlated with LVEF (r=-0.529) and showed high diagnostic accuracy (AUC=0.821).
• In older children (7-16 years), EMAT demonstrated superior performance (r=-0.609, AUC=0.896), with specific cutoffs identified for sensitivity and specificity.

Conclusions:

• The synchronized HS-ECG system provides valuable biomarkers for diagnosing pediatric LVSD.
• Diagnostic performance of CABs is age-dependent, with EMATc optimal for younger children (3-6 years) and EMAT for older children (7-16 years).