Noninvasive Prediction of Left Ventricular Systolic Dysfunction in Patients With Clinically Suspected Heart Failure Using Acoustic Cardiography

Abstract

The signs and symptoms of systolic heart failure are frequently insensitive and nonspecific, making an accurate bedside diagnosis of left ventricular systolic dysfunction (LVSD) challenging. B-type natriuretic peptide (BNP) is often used, but is not diagnostically useful when in the indeterminate range. The authors investigated the diagnostic test characteristics of acoustic cardiographic parameters to identify patients with LVSD. Four hundred thirty-three patients with contemporaneous measurements of computerized acoustic cardiography, BNP, and echocardiography were included. The acoustic cardiographic model outperformed BNP alone at detecting reduced left ventricular ejection fraction (C statistic, 0.88 vs 0.67; P<.0001). The acoustic model with BNP did not perform better than the acoustic model alone (P=.14). Within the indeterminate BNP range, the acoustic model outperformed BNP (C statistic, 0.89 vs 0.64; P<.0001). Noninvasive computerized acoustic cardiography predicted LVSD in a diverse population. This acoustic cardiographic model outperformed BNP alone for predicting LVSD.