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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
An Integrated Heart Sound-Electrocardiogram Synchronization System for Early Detecting Left Ventricular Systolic
Chun-Mei Gao1, Fan Xie1, Han Gao1
1Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China.
Insights
A novel synchronized heart sound-electrocardiogram (HS-ECG) system effectively detects pediatric left ventricular systolic dysfunction (LVSD). The system uses cardiac acoustic biomarkers (CABs) and shows age-dependent efficacy for early diagnosis in children.
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).
Background:
Early detection of pediatric left ventricular systolic dysfunction (LVSD) remains challenging in resource-limited settings. This study evaluates a novel synchronized heart sound-electrocardiogram (HS-ECG) system for LVSD detection in underserved pediatric populations.
Hypothesis:
Cardiac acoustic biomarkers (CABs) enable age-specific early detection of pediatric LVSD.
Methods:
This prospective cohort study enrolled 212 children aged 3-16 years, classified into case (LVEF ≤ 55%, n = 80) and control (LVEF > 55%, n = 132) groups with age stratification (3-6 and 7-16 years). All underwent synchronized HS-ECG recording using a high-fidelity wearable device. Signals were processed via wavelet analysis to derive CABs including electromechanical activation time (EMAT), pre - ejection period (PEP), left ventricular ejection time (LVET), left ventricular systolic time (LVST), their rate-corrected values (EMATc, PEPc, LVETc, LVSTc), and the PEP/LVET ratio. Echocardiographic LVEF served as the reference standard.
Results:
In children aged 3-6 years, EMATc showed strong inverse correlation with LVEF (r = -0.529, p < 0.001) and AUC = 0.821 (cutoff: 11.80%; sensitivity 82.5%, specificity 84.7%). In those aged 7-16 years, EMAT demonstrated superior performance (r = -0.609, p < 0.001; AUC = 0.896; cutoff: 82.50 ms; sensitivity 82.5%, specificity 93.2%).
Conclusion:
The synchronized HS-ECG system provides clinically valuable biomarkers for pediatric LVSD diagnosis, demonstrating distinct age-dependent diagnostic patterns: EMATc shows optimal performance in younger children (3-6 years), while EMAT exhibits superior efficacy in older children (7-16 years).
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