Leonardo Calò1, Alessandro Capucci2, Luca Santini3, Domenico Pecora4, Stefano Favale5, Barbara Petracci6, Giulio Molon7, Valter Bianchi8, Laura Cipolletta2, Ermenegildo De Ruvo9, Fabrizio Ammirati3, Carmelo La Greca4, Monica Campari10, Sergio Valsecchi10, Antonio D'Onofrio8. 1. Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169, Rome, Italy. leonardocalo.doc@gmail.com. 2. Università Politecnica delle Marche, Ancona, Italy. 3. "Giovan Battista Grassi" Hospital, Rome, Ostia lido, Italy. 4. Fondazione Poliambulanza, Brescia, Italy. 5. University of Bari, Policlinico di Bari, Bari, Italy. 6. Fondazione Policlinico S. Matteo IRCCS, Pavia, Italy. 7. Sacro Cuore-Don Calabria Hospital, Verona, Negrar, Italy. 8. Unità Operativa di Elettrofisiologia, Studio e Terapia delle Aritmie, Monaldi Hospital, Naples, Italy. 9. Division of Cardiology, Policlinico Casilino, Via Casilina 1049, 00169, Rome, Italy. 10. Boston Scientific Italia, Milan, Italy.
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.
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.
Authors: Roy S Gardner; Antonio D'Onofrio; George Mark; Daniel Gras; Yan Hu; Sara Veraghtert; Ignacio Garcia-Bolao Journal: ESC Heart Fail Date: 2021-01-19
Authors: Michelle Feijen; Anastasia D Egorova; Roderick W Treskes; Bart J A Mertens; J Wouter Jukema; Martin J Schalij; Saskia L M A Beeres Journal: Front Cardiovasc Med Date: 2022-05-06