ICD-measured heart sounds and their correlation with echocardiographic indexes of systolic and diastolic function

Leonardo Calò, Alessandro Capucci, Luca Santini, Domenico Pecora, Stefano Favale, Barbara Petracci, Giulio Molon, Valter Bianchi, Laura Cipolletta, Ermenegildo De Ruvo, Fabrizio Ammirati, Carmelo La Greca, Monica Campari, Sergio Valsecchi, Antonio D’Onofrio

Research output: Contribution to journalArticle

Abstract

Background: Novel implantable defibrillators (ICDs) allow first (S1) and third (S3) heart sounds to be measured by means of an embedded accelerometer. ICD-measured S1 and S3 have been shown to significantly correlate with hemodynamic changes in acute animal models. The HeartLogic algorithm (Boston Scientific) measures and combines multiple parameters, including S3 and S1, into a single index to predict impending heart failure decompensation. We evaluated the echocardiographic correlates of ICD-measured S1 and S3 in patients with ICD and cardiac resynchronization therapy ICD. Methods: The HeartLogic feature was activated in 104 patients. During in-office visits, patients underwent echocardiographic evaluation, and parameters of systolic and diastolic function were correlated with S3 and S1 amplitude measured on the same day as the visit. Results: S3 amplitude inversely correlated with deceleration time of the E-wave (r = −0.32; 95% CI -0.46 – -0.17; P < 0.001), and S1 amplitude significantly correlated with left ventricular ejection fraction (r = 0.17; 95% CI 0.03–0.30; P = 0.021). S3 > 0.9 mG detected a restrictive filling pattern with 85% (95% CI 72%–93%) sensitivity and 82% (95% CI 75%–88%) specificity, while S1 < 1.5 mG detected ejection fraction < 35% with 28% (95% CI 19%–40%) sensitivity and 88% (95% CI 80%–93%) specificity. Conclusion: ICD-measured heart sound parameters are significantly correlated with echocardiographic indexes of systolic and diastolic function. This confirms their utility for remote patient monitoring when used as single sensors and their potential relevance when considered in combination with other physiological ICD sensors that evaluate various aspects of heart failure physiology.

Original languageEnglish
JournalJournal of Interventional Cardiac Electrophysiology
DOIs
Publication statusAccepted/In press - Jan 1 2020

Keywords

  • Diastole
  • Heart failure
  • Heart sounds
  • ICD
  • Systole

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

ICD-measured heart sounds and their correlation with echocardiographic indexes of systolic and diastolic function. / Calò, Leonardo; Capucci, Alessandro; Santini, Luca; Pecora, Domenico; Favale, Stefano; Petracci, Barbara; Molon, Giulio; Bianchi, Valter; Cipolletta, Laura; De Ruvo, Ermenegildo; Ammirati, Fabrizio; La Greca, Carmelo; Campari, Monica; Valsecchi, Sergio; D’Onofrio, Antonio.

In: Journal of Interventional Cardiac Electrophysiology, 01.01.2020.

Research output: Contribution to journalArticle

Calò, L, Capucci, A, Santini, L, Pecora, D, Favale, S, Petracci, B, Molon, G, Bianchi, V, Cipolletta, L, De Ruvo, E, Ammirati, F, La Greca, C, Campari, M, Valsecchi, S & D’Onofrio, A 2020, 'ICD-measured heart sounds and their correlation with echocardiographic indexes of systolic and diastolic function', Journal of Interventional Cardiac Electrophysiology. https://doi.org/10.1007/s10840-019-00668-y
Calò, Leonardo ; Capucci, Alessandro ; Santini, Luca ; Pecora, Domenico ; Favale, Stefano ; Petracci, Barbara ; Molon, Giulio ; Bianchi, Valter ; Cipolletta, Laura ; De Ruvo, Ermenegildo ; Ammirati, Fabrizio ; La Greca, Carmelo ; Campari, Monica ; Valsecchi, Sergio ; D’Onofrio, Antonio. / ICD-measured heart sounds and their correlation with echocardiographic indexes of systolic and diastolic function. In: Journal of Interventional Cardiac Electrophysiology. 2020.
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abstract = "Background: Novel implantable defibrillators (ICDs) allow first (S1) and third (S3) heart sounds to be measured by means of an embedded accelerometer. ICD-measured S1 and S3 have been shown to significantly correlate with hemodynamic changes in acute animal models. The HeartLogic algorithm (Boston Scientific) measures and combines multiple parameters, including S3 and S1, into a single index to predict impending heart failure decompensation. We evaluated the echocardiographic correlates of ICD-measured S1 and S3 in patients with ICD and cardiac resynchronization therapy ICD. Methods: The HeartLogic feature was activated in 104 patients. During in-office visits, patients underwent echocardiographic evaluation, and parameters of systolic and diastolic function were correlated with S3 and S1 amplitude measured on the same day as the visit. Results: S3 amplitude inversely correlated with deceleration time of the E-wave (r = −0.32; 95{\%} CI -0.46 – -0.17; P < 0.001), and S1 amplitude significantly correlated with left ventricular ejection fraction (r = 0.17; 95{\%} CI 0.03–0.30; P = 0.021). S3 > 0.9 mG detected a restrictive filling pattern with 85{\%} (95{\%} CI 72{\%}–93{\%}) sensitivity and 82{\%} (95{\%} CI 75{\%}–88{\%}) specificity, while S1 < 1.5 mG detected ejection fraction < 35{\%} with 28{\%} (95{\%} CI 19{\%}–40{\%}) sensitivity and 88{\%} (95{\%} CI 80{\%}–93{\%}) specificity. Conclusion: ICD-measured heart sound parameters are significantly correlated with echocardiographic indexes of systolic and diastolic function. This confirms their utility for remote patient monitoring when used as single sensors and their potential relevance when considered in combination with other physiological ICD sensors that evaluate various aspects of heart failure physiology.",
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T1 - ICD-measured heart sounds and their correlation with echocardiographic indexes of systolic and diastolic function

AU - Calò, Leonardo

AU - Capucci, Alessandro

AU - Santini, Luca

AU - Pecora, Domenico

AU - Favale, Stefano

AU - Petracci, Barbara

AU - Molon, Giulio

AU - Bianchi, Valter

AU - Cipolletta, Laura

AU - De Ruvo, Ermenegildo

AU - Ammirati, Fabrizio

AU - La Greca, Carmelo

AU - Campari, Monica

AU - Valsecchi, Sergio

AU - D’Onofrio, Antonio

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Background: Novel implantable defibrillators (ICDs) allow first (S1) and third (S3) heart sounds to be measured by means of an embedded accelerometer. ICD-measured S1 and S3 have been shown to significantly correlate with hemodynamic changes in acute animal models. The HeartLogic algorithm (Boston Scientific) measures and combines multiple parameters, including S3 and S1, into a single index to predict impending heart failure decompensation. We evaluated the echocardiographic correlates of ICD-measured S1 and S3 in patients with ICD and cardiac resynchronization therapy ICD. Methods: The HeartLogic feature was activated in 104 patients. During in-office visits, patients underwent echocardiographic evaluation, and parameters of systolic and diastolic function were correlated with S3 and S1 amplitude measured on the same day as the visit. Results: S3 amplitude inversely correlated with deceleration time of the E-wave (r = −0.32; 95% CI -0.46 – -0.17; P < 0.001), and S1 amplitude significantly correlated with left ventricular ejection fraction (r = 0.17; 95% CI 0.03–0.30; P = 0.021). S3 > 0.9 mG detected a restrictive filling pattern with 85% (95% CI 72%–93%) sensitivity and 82% (95% CI 75%–88%) specificity, while S1 < 1.5 mG detected ejection fraction < 35% with 28% (95% CI 19%–40%) sensitivity and 88% (95% CI 80%–93%) specificity. Conclusion: ICD-measured heart sound parameters are significantly correlated with echocardiographic indexes of systolic and diastolic function. This confirms their utility for remote patient monitoring when used as single sensors and their potential relevance when considered in combination with other physiological ICD sensors that evaluate various aspects of heart failure physiology.

AB - Background: Novel implantable defibrillators (ICDs) allow first (S1) and third (S3) heart sounds to be measured by means of an embedded accelerometer. ICD-measured S1 and S3 have been shown to significantly correlate with hemodynamic changes in acute animal models. The HeartLogic algorithm (Boston Scientific) measures and combines multiple parameters, including S3 and S1, into a single index to predict impending heart failure decompensation. We evaluated the echocardiographic correlates of ICD-measured S1 and S3 in patients with ICD and cardiac resynchronization therapy ICD. Methods: The HeartLogic feature was activated in 104 patients. During in-office visits, patients underwent echocardiographic evaluation, and parameters of systolic and diastolic function were correlated with S3 and S1 amplitude measured on the same day as the visit. Results: S3 amplitude inversely correlated with deceleration time of the E-wave (r = −0.32; 95% CI -0.46 – -0.17; P < 0.001), and S1 amplitude significantly correlated with left ventricular ejection fraction (r = 0.17; 95% CI 0.03–0.30; P = 0.021). S3 > 0.9 mG detected a restrictive filling pattern with 85% (95% CI 72%–93%) sensitivity and 82% (95% CI 75%–88%) specificity, while S1 < 1.5 mG detected ejection fraction < 35% with 28% (95% CI 19%–40%) sensitivity and 88% (95% CI 80%–93%) specificity. Conclusion: ICD-measured heart sound parameters are significantly correlated with echocardiographic indexes of systolic and diastolic function. This confirms their utility for remote patient monitoring when used as single sensors and their potential relevance when considered in combination with other physiological ICD sensors that evaluate various aspects of heart failure physiology.

KW - Diastole

KW - Heart failure

KW - Heart sounds

KW - ICD

KW - Systole

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