Acoustic cardiography S3 detection use in problematic subgroups and B-type natriuretic peptide "gray zone": secondary results from the Heart failure and Audicor technology for Rapid Diagnosis and Initial Treatment Multinational Investigation

The American Journal of Emergency Medicine
Alan MaiselSean P Collins

Abstract

Dyspneic emergency department (ED) patients present a diagnostic dilemma. The S3, although highly specific for acute heart failure (AHF) and predicting death and readmission, is often difficult to auscultate. The HEart failure and Audicor technology for Rapid Diagnosis and Initial Treatment (HEARD-IT) multinational trial evaluated the S3 via acoustic cardiography (Audicor). Our goal in this secondary analysis was to determine if the strength of the S3 can provide diagnostic/prognostic information in problematic heart failure subgroups. Dyspneic ED patients older than 40 years and not on dialysis were prospectively enrolled. A gold standard AHF diagnosis was determined by 2 cardiologists blinded to acoustic cardiography results. The S3 strength parameter was delineated on a scale of 0 to 10. This secondary analysis of subgroups from the HEARD-IT database used univariate/multivariate regression to determine the diagnostic/prognostic ability of the S3 strength. In the 995 patients enrolled, S3 strength was a significant prognosticator in univariate analysis for adverse events but not in a multivariable model. In patients with "gray zone" B-type natriuretic peptide (BNP) levels (100-499 pg/mL), acoustic cardiography increased diagn...Continue Reading

References

Jun 4, 2004·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Eric Schwam
Nov 10, 2004·Archives of Internal Medicine·James McCordUNKNOWN Breathing Not Properly Multinational Study Investigators
May 12, 2005·JAMA : the Journal of the American Medical Association·Gregory M MarcusAndrew D Michaels
Oct 20, 2005·JAMA : the Journal of the American Medical Association·Charlie S WangNajib T Ayas
Dec 13, 2005·The American Journal of Emergency Medicine·Sean P CollinsAlan B Storrow
Aug 9, 2006·Congestive Heart Failure·Michel ZuberChristine Attenhofer Jost
Feb 24, 2009·Annals of Emergency Medicine·Sean P CollinsAlan Maisel

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Citations

Feb 26, 2016·Chinese Medical Journal·Dong-Hui HuangJing-Pu Shi
Feb 18, 2014·International Journal of Cardiology·Yong-Na WenCheuk-Man Yu
Nov 30, 2019·Disease Markers·Hui-Ju TsaiHung-Chun Chen

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