PS-C24-4: QUANTIFICATION OF EXERCISE-INDUCED HEMODYNAMIC CHANGE BY HEART SOUND ANALYSIS IN PATIENT WITH HEART FAILURE

Abstract

Objective: Since an elevation of pulmonary artery pressure (PAP) often precedes clinical worsening of heart failure, early and non-invasive detection of that sign is useful in heart failure care. The purpose of this study was to assess whether a non-invasive technology called cardiac acoustic biomarkers (CABs) to quantify heart sounds can detect the exercise-induced elevation of PAP in patients with heart failure. Design and Methods: Patients with heart failure scheduled to undergo right heart catheterization (RHC) were prospectively enrolled between February 2020 to September 2021. CABs were concurrently recorded with PAP and pulmonary capillary wedge pressure (PCWP) at rest (baseline) and while applying a handgrip (exercise). Results: Forty-nine patients were included in the analysis dataset and their mean PAP significantly increased at exercise compared to baseline (32.45 ± 11.28 mmHg vs 23.52 ± 8.41 mmHg; p < 0.001). Several CABs correlated significantly with mean PAP by absolute values, among which S2 Width (r = 0.354; p < 0.05 and r = 0.363; p < 0.05) and S3 Strength (r = 0.375; p < 0.05 and r = 0.386; p < 0.05) were consistent throughout baseline and exercise. The response of CABs to PAP elevation caused by exercise was divided into two patterns: increasing and decreasing. The frequency of cardiac index less than 2.2 mL/m2 was significantly higher in the decreasing pattern. Conclusions: CABs related to S2 and S3 can quantify heart sounds which reflect the exercise-induced hemodynamic change in patients with heart failure. It should be noted, however, that their reactions to hemodynamic change can be different depending on the background hemodynamics of individuals.