The Experts below are selected from a list of 264 Experts worldwide ranked by ideXlab platform
Paul Erne - One of the best experts on this subject based on the ideXlab platform.
-
noninvasive detection of left ventricular systolic dysfunction by acoustic Cardiography in atrial fibrillation
Cardiology Research and Practice, 2011Co-Authors: Roger Dillier, Michel Zuber, Richard Kobza, Susanne Erne, Patricia Arand, Paul ErneAbstract:Objectives. Assessment of left ventricular (LV) systolic function in patients with atrial fibrillation can be difficult. Acoustic Cardiography provides several parameters for quantifying LV systolic function. We evaluated the ability of acoustic Cardiography to detect LV systolic dysfunction in patients with and without atrial fibrillation. Design. We studied 194 patients who underwent acoustic Cardiography and cardiac catheterization including measurement of angiographic ejection fraction (EF) and maximum LV dP/dt. LV systolic dysfunction was defined as LV maximum dP/dt <1600 mmHg/s. Acoustic cardiographic parameters included electromechanical activation time (EMAT) and the systolic dysfunction index (SDI). Results. Acoustic Cardiography detected systolic dysfunction with high specificity and moderate sensitivity with similar performance to EF (sensitivity/specificity without afib: EMAT 30/96, SDI 40/90, EF at 35% 30/96; sensitivity/specificity with afib: EMAT 64/82, SDI 59/100, EF at 35% 45/82). Conclusions. Acoustic Cardiography can be used for diagnosis of LV systolic dysfunction in atrial fibrillation.
-
Noninvasive Detection of Left-Ventricular Systolic Dysfunction by Acoustic Cardiography in Atrial Fibrillation
Cardiology Research and Practice, 2010Co-Authors: Roger Dillier, Michel Zuber, Richard Kobza, Susanne Erne, Patricia Arand, Paul ErneAbstract:Objectives. Assessment of left ventricular (LV) systolic function in patients with atrial fibrillation can be difficult. Acoustic Cardiography provides several parameters for quantifying LV systolic function. We evaluated the ability of acoustic Cardiography to detect LV systolic dysfunction in patients with and without atrial fibrillation. Design. We studied 194 patients who underwent acoustic Cardiography and cardiac catheterization including measurement of angiographic ejection fraction (EF) and maximum LV dP/dt. LV systolic dysfunction was defined as LV maximum dP/dt
-
Acoustic Cardiography to improve detection of coronary artery disease with stress testing.
World Journal of Cardiology, 2010Co-Authors: Michel Zuber, Paul ErneAbstract:AIM: To assess if performance of 12-lead exercise tolerance testing (ETT) can be improved by simultaneous acoustic Cardiography and to compare the diagnostic performances of electroCardiography (ECG) during ETT and acoustic Cardiography for detection or exclusion of angiographically proven coronary artery disease (CAD). METHODS: We conducted an explorative study with retrospective data analysis using a convenience sample of consecutive patients (n = 59, mean age: 62 years) from an outpatient clinic in Switzerland, who were referred for ETT by their general practitioner on suspicion of CAD, and in whom, coronary angiography was carried out. Measurements included sensitivity, specificity, likelihood ratios and receiver operating characteristic curves. A standard, symptom-limited, 12-lead ECG exercise tolerance test was performed by independent persons with simultaneous acoustic Cardiography and subsequent cardiac angiography for determination of significant CAD. RESULTS: Thirty-four of the 59 adult subjects (58%) had a final diagnosis of CAD by angiography, and in 25 subjects, CAD was excluded by angiography. Sensitivity/specificity of ST segment depression in the group was 29%/92%, whereas the most powerful acoustic cardiographic parameter was the strength of the fourth heart sound (S4), with corresponding sensitivity/specificity of 53%/92%. The disjunctive combination of the S4 and ST depression had sensitivity/specificity of 68%/84%. CONCLUSION: In this preliminary pilot study, the use of acoustic Cardiography alone during ETT or disjunctively with ST depression has been shown to be a simple and convenient method for the detection of CAD, which was superior to ST depression on the standardized ECG.
-
a comparison of acoustic Cardiography and echoCardiography for optimizing pacemaker settings in cardiac resynchronization therapy
Pacing and Clinical Electrophysiology, 2008Co-Authors: Michel Zuber, Stefan Toggweiler, Lori Quinntate, Lei Brown, Ali Amkieh, Paul ErneAbstract:BACKGROUND: Cardiac resynchronization therapy (CRT) is useful in managing patients with refractory heart failure. To increase efficacy, pacemaker settings are optimized, with Doppler echoCardiography being the preferred method. Recently, acoustic Cardiography, an automated method that records, analyzes, and displays simultaneous ECG and heart sound data, has been developed. In this study, the suitability of acoustic Cardiography as an alternative to Doppler echoCardiography in CRT optimization is evaluated. METHODS: We studied 43 CRT patients undergoing optimization. Using Doppler echoCardiography, we determined the optimal atrioventricular (AV) delay with a transmitral flow assessment. For optimization of the interventricular (VV) delay, we used the left ventricular outflow tract velocity time integral (VTI). For acoustic Cardiography, we used the electromechanical activation time (EMAT, the interval from QRS onset to the S1). Reproducibility of echoCardiography and acoustic Cardiography was determined by programming 10 different delay settings twice in random order. RESULTS: All 43 subjects underwent AV optimization, and 14 had CRT devices allowing VV optimization. While the intraobserver variability of EMAT and Doppler echoCardiography parameter was similar (9.9% vs 8.5%), the reproducibility of EMAT was the highest (r = 0.91) and VTI was the lowest (r = 0.35). The correlation between the optimal AV delays determined by EMAT versus transmitral flow assessment was 0.86 (P > 0.001). The correlation between the optimal VV delays determined by EMAT versus VTI was 0.58 (P > 0.05), perhaps due to the poor reproducibility of the VTI. CONCLUSION: For CRT optimization, acoustic Cardiography provides results similar to echoCardiography but with improved reproducibility and ease of use.
-
noninvasive detection of left ventricular systolic dysfunction by acoustic Cardiography in cardiac failure patients
Journal of Cardiac Failure, 2008Co-Authors: Markus Roos, Michel Zuber, Richard Kobza, Stefan Toggweiler, Peiman Jamshidi, Rolf Meier, Paul ErneAbstract:Abstract Background Despite its shortcomings, ejection fraction (EF) is widely used to detect left ventricular systolic dysfunction (LVSD) as has prolonged QRS duration as indirect evidence of LVSD. However, acoustic Cardiography provides other parameters for detecting LVSD without these limitations. One parameter, the electromechanical activation time (EMAT), is prolonged in LVSD. We compared the abilities of acoustic Cardiography, EF, and QRS duration to detect LVSD. Methods and Results We studied a sample of 108 patients who underwent elective diagnostic cardiac catheterization. The diagnostic findings included left ventricular filling pressures, angiographic EF, and maximum left ventricular dP/dt. We defined LVSD as a maximum left ventricular dP/dt of Conclusions Acoustic Cardiography is a convenient, automated diagnostic method whose performance for detecting LVSD exceeds both angiographic EF and QRS duration alone.
Kamal K. Mubarak - One of the best experts on this subject based on the ideXlab platform.
-
Value of Impedance Cardiography in Patients Studied for Pulmonary Hypertension
Lung, 2011Co-Authors: Adriano R. Tonelli, Hassan Alnuaimat, Ning Li, Robin Carrie, Kamal K. MubarakAbstract:The aim of this study was to evaluate the accuracy and precision of impedance Cardiography as a method for noninvasive hemodynamic evaluation of patients with pulmonary hypertension (PH). We performed a prospective and blinded study of patients who underwent right heart catheterization (RHC) for evaluation of known or presumed PH at the University of Florida from August 2009 to March 2010. The cohort consisted of a total of 39 patients (age = 57 ± 14 years, 87% women) with presumed (23%) or confirmed PH (77%) of different etiologies. Patients underwent RHC and impedance Cardiography using the PhysioFlow PF-05. The PhysioFlow PF-05 measures cardiac output (CO) and LV end-diastolic volume (LVEDV), among other parameters. The median pulmonary artery pressure was 36 (IQR 26-56) mmHg. The CO (mean ± SD) by thermodilution (CO-T) and by impedance Cardiography (CO-IC) was 5.9 ± 2.2 and 5.6 ± 1.5 L/min, respectively. Bland-Altman analysis of CO-T versus CO-IC revealed a mean of 0.3 L/min (95% LoA: −2.2 to +2.8). In patients with PH, the correlation of CO-T and CO-IC had a mean of 0.4 L/min (95% LoA: 2.9 and −2.2). Pulmonary artery occlusion pressure (PAOP) correlated with LVEDV ( R ^2 = 0.2, p = 0.005). By ROC analysis, EDV ≥ 200 ml had a sensitivity of 53% and a specificity of 86% for PAOP > 15 mmHg (AUC = 0.78). In patients with PH, impedance Cardiography had good accuracy and fair precision for CO determination when compared with thermodilution. Impedance Cardiography may provide information about the preload status and has the potential to become a cost-effective and noninvasive method for the follow-up of patients with PH.
Michel Zuber - One of the best experts on this subject based on the ideXlab platform.
-
noninvasive detection of left ventricular systolic dysfunction by acoustic Cardiography in atrial fibrillation
Cardiology Research and Practice, 2011Co-Authors: Roger Dillier, Michel Zuber, Richard Kobza, Susanne Erne, Patricia Arand, Paul ErneAbstract:Objectives. Assessment of left ventricular (LV) systolic function in patients with atrial fibrillation can be difficult. Acoustic Cardiography provides several parameters for quantifying LV systolic function. We evaluated the ability of acoustic Cardiography to detect LV systolic dysfunction in patients with and without atrial fibrillation. Design. We studied 194 patients who underwent acoustic Cardiography and cardiac catheterization including measurement of angiographic ejection fraction (EF) and maximum LV dP/dt. LV systolic dysfunction was defined as LV maximum dP/dt <1600 mmHg/s. Acoustic cardiographic parameters included electromechanical activation time (EMAT) and the systolic dysfunction index (SDI). Results. Acoustic Cardiography detected systolic dysfunction with high specificity and moderate sensitivity with similar performance to EF (sensitivity/specificity without afib: EMAT 30/96, SDI 40/90, EF at 35% 30/96; sensitivity/specificity with afib: EMAT 64/82, SDI 59/100, EF at 35% 45/82). Conclusions. Acoustic Cardiography can be used for diagnosis of LV systolic dysfunction in atrial fibrillation.
-
Noninvasive Detection of Left-Ventricular Systolic Dysfunction by Acoustic Cardiography in Atrial Fibrillation
Cardiology Research and Practice, 2010Co-Authors: Roger Dillier, Michel Zuber, Richard Kobza, Susanne Erne, Patricia Arand, Paul ErneAbstract:Objectives. Assessment of left ventricular (LV) systolic function in patients with atrial fibrillation can be difficult. Acoustic Cardiography provides several parameters for quantifying LV systolic function. We evaluated the ability of acoustic Cardiography to detect LV systolic dysfunction in patients with and without atrial fibrillation. Design. We studied 194 patients who underwent acoustic Cardiography and cardiac catheterization including measurement of angiographic ejection fraction (EF) and maximum LV dP/dt. LV systolic dysfunction was defined as LV maximum dP/dt
-
Acoustic Cardiography to improve detection of coronary artery disease with stress testing.
World Journal of Cardiology, 2010Co-Authors: Michel Zuber, Paul ErneAbstract:AIM: To assess if performance of 12-lead exercise tolerance testing (ETT) can be improved by simultaneous acoustic Cardiography and to compare the diagnostic performances of electroCardiography (ECG) during ETT and acoustic Cardiography for detection or exclusion of angiographically proven coronary artery disease (CAD). METHODS: We conducted an explorative study with retrospective data analysis using a convenience sample of consecutive patients (n = 59, mean age: 62 years) from an outpatient clinic in Switzerland, who were referred for ETT by their general practitioner on suspicion of CAD, and in whom, coronary angiography was carried out. Measurements included sensitivity, specificity, likelihood ratios and receiver operating characteristic curves. A standard, symptom-limited, 12-lead ECG exercise tolerance test was performed by independent persons with simultaneous acoustic Cardiography and subsequent cardiac angiography for determination of significant CAD. RESULTS: Thirty-four of the 59 adult subjects (58%) had a final diagnosis of CAD by angiography, and in 25 subjects, CAD was excluded by angiography. Sensitivity/specificity of ST segment depression in the group was 29%/92%, whereas the most powerful acoustic cardiographic parameter was the strength of the fourth heart sound (S4), with corresponding sensitivity/specificity of 53%/92%. The disjunctive combination of the S4 and ST depression had sensitivity/specificity of 68%/84%. CONCLUSION: In this preliminary pilot study, the use of acoustic Cardiography alone during ETT or disjunctively with ST depression has been shown to be a simple and convenient method for the detection of CAD, which was superior to ST depression on the standardized ECG.
-
Diagnosis and characterization of left ventricular hypertrophy by computerized acoustic Cardiography, brain natriuretic peptide, and electroCardiography
Journal of Electrocardiology, 2008Co-Authors: R. Kevin Rogers, Sean P. Collins, Michael C. Kontos, Michel Zuber, Patti Arand, Andrew D. MichaelsAbstract:BACKGROUND: Using echoCardiography as the gold standard to diagnose and classify subtypes of left ventricular hypertrophy (LVH), we compared the diagnostic accuracy of computerized acoustic Cardiography, brain natriuretic peptide (BNP), and the Cornell voltage criteria. METHODS: Three hundred fifty-two patients with suspected heart failure had contemporaneous BNP sampling, 12-lead electroCardiography, computerized acoustic Cardiography, and echoCardiography. Left ventricular hypertrophy was classified as eccentric vs concentric based on echocardiographic relative wall thickness. Computerized acoustic Cardiography was used to measure acoustic and automated electrical parameters. RESULTS: Of all models, BNP combined with either computerized acoustic Cardiography (c-statistic, 0.78; 95% confidence interval [CI], 0.74-0.78) or Cornell voltage (c-statistic, 0.76; 95% CI, 0.71-0.81) had the best diagnostic performance for LVH detection. For LVH characterization, the computerized acoustic Cardiography model outperformed other models (c-statistic, 0.73; 95% CI, 0.66-0.80). CONCLUSIONS: Brain natriuretic peptide combined with either computerized acoustic Cardiography or Cornell voltage had the highest diagnostic accuracy for the detection of LVH, compared to Cornell voltage, BNP, or computerized acoustic Cardiography alone. Computerized acoustic Cardiography outperformed other models for the characterization of LVH subtypes.
-
a comparison of acoustic Cardiography and echoCardiography for optimizing pacemaker settings in cardiac resynchronization therapy
Pacing and Clinical Electrophysiology, 2008Co-Authors: Michel Zuber, Stefan Toggweiler, Lori Quinntate, Lei Brown, Ali Amkieh, Paul ErneAbstract:BACKGROUND: Cardiac resynchronization therapy (CRT) is useful in managing patients with refractory heart failure. To increase efficacy, pacemaker settings are optimized, with Doppler echoCardiography being the preferred method. Recently, acoustic Cardiography, an automated method that records, analyzes, and displays simultaneous ECG and heart sound data, has been developed. In this study, the suitability of acoustic Cardiography as an alternative to Doppler echoCardiography in CRT optimization is evaluated. METHODS: We studied 43 CRT patients undergoing optimization. Using Doppler echoCardiography, we determined the optimal atrioventricular (AV) delay with a transmitral flow assessment. For optimization of the interventricular (VV) delay, we used the left ventricular outflow tract velocity time integral (VTI). For acoustic Cardiography, we used the electromechanical activation time (EMAT, the interval from QRS onset to the S1). Reproducibility of echoCardiography and acoustic Cardiography was determined by programming 10 different delay settings twice in random order. RESULTS: All 43 subjects underwent AV optimization, and 14 had CRT devices allowing VV optimization. While the intraobserver variability of EMAT and Doppler echoCardiography parameter was similar (9.9% vs 8.5%), the reproducibility of EMAT was the highest (r = 0.91) and VTI was the lowest (r = 0.35). The correlation between the optimal AV delays determined by EMAT versus transmitral flow assessment was 0.86 (P > 0.001). The correlation between the optimal VV delays determined by EMAT versus VTI was 0.58 (P > 0.05), perhaps due to the poor reproducibility of the VTI. CONCLUSION: For CRT optimization, acoustic Cardiography provides results similar to echoCardiography but with improved reproducibility and ease of use.
Jeanluc Fellahi - One of the best experts on this subject based on the ideXlab platform.
-
can endotracheal bioimpedance Cardiography assess hemodynamic response to passive leg raising following cardiac surgery
Annals of Intensive Care, 2012Co-Authors: Jeanluc Fellahi, Marcolivier Fischer, Audrey Dalbera, Massimo Massetti, J L Gerard, J L HanouzAbstract:Background The utility of endotracheal bioimpedance Cardiography (ECOM) has been scarcely reported. We tested the hypothesis that it could be an alternative to pulse contour analysis for cardiac index measurement and prediction in fluid responsiveness.
-
noninvasive assessment of cardiac index in healthy volunteers a comparison between thoracic impedance Cardiography and doppler echoCardiography
Anesthesia & Analgesia, 2009Co-Authors: Jeanluc Fellahi, Vincent Caille, Cyril Charron, Pierreherve Deschampsberger, Antoine VieillardbaronAbstract:BACKGROUND:Thoracic bioimpedance Cardiography (ICG) has been proposed as a noninvasive, continuous, operator-independent, and cost-effective method for cardiac output monitoring. In the present study, we compared cardiac index (CI) measurements with ICG (Niccomo™ device) and transthoracic Doppler ec
Stefan Toggweiler - One of the best experts on this subject based on the ideXlab platform.
-
a comparison of acoustic Cardiography and echoCardiography for optimizing pacemaker settings in cardiac resynchronization therapy
Pacing and Clinical Electrophysiology, 2008Co-Authors: Michel Zuber, Stefan Toggweiler, Lori Quinntate, Lei Brown, Ali Amkieh, Paul ErneAbstract:BACKGROUND: Cardiac resynchronization therapy (CRT) is useful in managing patients with refractory heart failure. To increase efficacy, pacemaker settings are optimized, with Doppler echoCardiography being the preferred method. Recently, acoustic Cardiography, an automated method that records, analyzes, and displays simultaneous ECG and heart sound data, has been developed. In this study, the suitability of acoustic Cardiography as an alternative to Doppler echoCardiography in CRT optimization is evaluated. METHODS: We studied 43 CRT patients undergoing optimization. Using Doppler echoCardiography, we determined the optimal atrioventricular (AV) delay with a transmitral flow assessment. For optimization of the interventricular (VV) delay, we used the left ventricular outflow tract velocity time integral (VTI). For acoustic Cardiography, we used the electromechanical activation time (EMAT, the interval from QRS onset to the S1). Reproducibility of echoCardiography and acoustic Cardiography was determined by programming 10 different delay settings twice in random order. RESULTS: All 43 subjects underwent AV optimization, and 14 had CRT devices allowing VV optimization. While the intraobserver variability of EMAT and Doppler echoCardiography parameter was similar (9.9% vs 8.5%), the reproducibility of EMAT was the highest (r = 0.91) and VTI was the lowest (r = 0.35). The correlation between the optimal AV delays determined by EMAT versus transmitral flow assessment was 0.86 (P > 0.001). The correlation between the optimal VV delays determined by EMAT versus VTI was 0.58 (P > 0.05), perhaps due to the poor reproducibility of the VTI. CONCLUSION: For CRT optimization, acoustic Cardiography provides results similar to echoCardiography but with improved reproducibility and ease of use.
-
noninvasive detection of left ventricular systolic dysfunction by acoustic Cardiography in cardiac failure patients
Journal of Cardiac Failure, 2008Co-Authors: Markus Roos, Michel Zuber, Richard Kobza, Stefan Toggweiler, Peiman Jamshidi, Rolf Meier, Paul ErneAbstract:Abstract Background Despite its shortcomings, ejection fraction (EF) is widely used to detect left ventricular systolic dysfunction (LVSD) as has prolonged QRS duration as indirect evidence of LVSD. However, acoustic Cardiography provides other parameters for detecting LVSD without these limitations. One parameter, the electromechanical activation time (EMAT), is prolonged in LVSD. We compared the abilities of acoustic Cardiography, EF, and QRS duration to detect LVSD. Methods and Results We studied a sample of 108 patients who underwent elective diagnostic cardiac catheterization. The diagnostic findings included left ventricular filling pressures, angiographic EF, and maximum left ventricular dP/dt. We defined LVSD as a maximum left ventricular dP/dt of Conclusions Acoustic Cardiography is a convenient, automated diagnostic method whose performance for detecting LVSD exceeds both angiographic EF and QRS duration alone.
-
improved response to cardiac resynchronization therapy through optimization of atrioventricular and interventricular delays using acoustic Cardiography a pilot study
Journal of Cardiac Failure, 2007Co-Authors: Stefan Toggweiler, Michel Zuber, Richard Kobza, Markus Roos, Peiman Jamshidi, Rolf Meier, Paul ErneAbstract:Abstract Background The purpose of this pilot study was to determine the utility of acoustic Cardiography for the optimization of atrioventricular (AV) and interventricular (VV) delays in cardiac resynchronization therapy (CRT). Methods and Results We evaluated 14 patients (86% male, mean age 64 ± 9 years, mean time since implant 15 ± 18 months). Subjects were enrolled >10 weeks after CRT implant. Spiroergometry and 2-dimensional/3-dimensional echoCardiography were used to assess cardiac performance for “out-of-the-box” settings (baseline settings: AV 120 ms, VV 0 ms) versus optimal settings (determined by acoustic Cardiography). Cardiac performance measurements were performed 6 weeks after settings were modified. Optimal AV/VV settings were determined based on the lowest electromechanical activation time (EMAT, the time from the onset of QRS to the mitral valve component of the first heart sound). Statistical analysis was performed using a paired 2-tailed Student's t -test. In comparison to “out-of-the-box” settings, AV/VV delay optimization with acoustic Cardiography improved cardiac performance as indicated by significant changes in work capacity, maximum oxygen uptake, oxygen pulse, ejection fraction, end-systolic volume, and velocity-time integral in left ventricular outflow tract. Conclusions AV and VV optimization by acoustic Cardiography produces significant improvements in objective clinical and hemodynamic parameters in comparison to typical “out-of-the-box” settings.