Evaluation Of Left Ventricular Systolic Function By Analysing Heart Sound-Electrocardiogram

Objective:Heart failure occurs in most of the End-stage of cardiovascular diseases.Myocardial infarction,cardiomyopathy,hemodynamic overload,inflammation and other diseases lead to myocardial damage,changes in cardiac structure and function,ventricular systolic and/or filling dysfunction.Patients with End-stage heart failure have poor quality of life,high medical costs and high mortality.Early detection of heart failure has now received increasing attention from the medical community.This article introduces a new type of collector which measures heart sound-electrocardiogram signal in order to compare electro-mechanical activation time signal(EMAT)between heart failure with reduced ejection fraction and non-heart failure patients;statistical significance of EMAT/RR,and its correlation with LVEF and NT-proBNP.And analyze the sensitivity and specificity of the EMAT time limit as a diagnostic basis.Making sure such diseases could be identified and intervened as soon as possible to furnish the basis for clinical application.Methods:We selected 189 patients who were admitted to Cardiovascular area at the Heart Center of our hospital from January,2016 to January,2018,76 patients with heart failure with reduced ejection fraction and 113 patients without heart failure throughout systematically collecting the patient's condition and carefully physical examination to obtain the clinical data of each patient: age,gender,blood pressure,blood lipid,blood glucose,oral medication,previous history,family history,etc.Then complete the following indexes: Blood cell analysis,liver and kidney function,blood glucose,NT-proBNP,echocardiography,etc.All heart failure with reduced ejection fraction patients require detailed systemic examination combined with clinical symptoms,NT-proBNP,echocardiography,and diagnosed by two experienced clinicians.Inform the patient and family members of the experimental goals and methods,and sign the informed consent after agreement.Heart sound-electrocardiogram acquisition and heart sound,ECG signal extraction method is as follows,the patient exposed their chest,the heart sound collector is placed at the heart apex of the patient try to avoid the interference of breath sounds on heart sound collector,through Bluetooth connected heart sound receiving equipment,the collector recorded 60 s of ECG signal of each patient.And heart sound-electrocardiogram automatic processing software collects each collector's heart sound-electrocardiogram signal indicators.The t-test was used to analyze whether the signals of EMAT and EMAT/RR has statistical differences between heart failure patients and non-heart failure patients.and the correlation with LVEF and NT-proBNP,and the sensitivity?specificity of EMAT diagnosis.Results:Analyzing the data by using statistical software SPSS 22.0,the EMAT index was statistically significant between the two groups,the EMAT/RR?S1-S2?S1-S2/RR indexs wasn't statistically significant and the EMAT(159.82±83)ms in the heart failure with reduced ejection fraction group was significantly increase than that in the non-heart failure group(91.58±28)ms.Pearson's correlation test showed that there was a correlation between EMAT and LVEF%(r=-0.449;P<0.001).The ROC curve analysis shows the sensitivity and specificity of EMAT?104ms for the diagnosis of heart failure with reduced ejection fraction were 92.1% and 92%,respectively.Conclusion:The heart sound-Electrocardiographic signal index EMAT contributes to the diagnosis of heart failure with reduced ejection fraction and its diagnostic value is higher than plasma NT-proBNP.