Diagnosis of Coronary Artery Disease by Acoustic Analysis of Turbulent Murmur Caused by Coronary Artery Stenosis:A Single Center Study from China  

作　　者：Pan-Guo Zhao Yi-Xiong Huang Li-Ping Xiao Jing Cui Dong-Tao Li Yi Cao Jiang-Chun He Yong Xu Jun Guo Hao Xue Yu Chen Tian-Chang Li 

机构地区：[1]Department of Cardiology,The Sixth Medical Center of Chinese People’s Liberation Army General Hospital,Beijing 100048,P.R.China [2]The Second School of Clinical Medicine,Southern Medical University,Guangzhou 510515,Guangdong,P.R.China [3]Department of Nephrology,Baiyun Branch of Nanfang Hospital of Southern Medical University,Guang’zhou 510000,P.R.China [4]Navy Clinical College,The Fifth School of Clinical Medicine,Anhui Medical University,Hefei,230032,P.R.China

出　　处：《Cardiovascular Innovations and Applications》2022年第3期102-112,共11页心血管创新与应用（英文）

基　　金：supported by research grants from the Innovation and Cultivation Fund of the Sixth Medical Center of Chinese People’s Liberation Army General Hospital(grant number:CXPY201925).

摘　　要：Aim:Intracoronary murmur results from turbulent flow due to coronary artery narrowing.This study evaluated the diagnostic performance of a method for acoustic analysis of turbulent murmur caused by coronary artery stenosis in coronary artery disease(CAD)in Chinese populations.Method:Patients admitted to the cardiovascular department of the Sixth Medical Center of the Chinese People’s Liberation Army General Hospital between September 2021 and June 2022 for elective coronary angiography were prospectively enrolled.A digital electronic stethoscope was used to record heart sounds before angiography.Quantitative coronary angiography(QCA)served as the“gold standard”for CAD diagnosis to evaluate the diagnostic performance of the acoustic analysis method for CAD.Results:A total of 452 patients had complete QCA and heart sound data.The final interpretation results of the acoustic analysis method indicated 310 disease cases and 142 normal results.Increasing the cut-off values of coronary artery diameter stenosis from 30%to 50%,70%,and 90%increased the sensitivity and NPV of the acoustic analysis method;the sensitivity was 75.6%,81.9%,83.3%,and 85.7%,respectively;the NPV was 33.1%,57.0%,69.7%,and 88.0%,respectively;the specificity and PPV decreased(specificity of 75.8%,70.4%,51.0%,and 37.5%,respectively;PPV of 95.2%,89.0%,69.4%,and 32.9%,respectively);and the AUC values were 0.757,0.762,0.672,and 0.616,respectively.The sensitivity of the acoustic analysis method for one-vessel disease was 86.6%when the cut-off value was 50%.The sensitivity for identifying left anterior descending coronary artery lesions was best,at 90.7%.The sensitivity for identifying isolated coronary artery branch lesions was 66.7%,whereas the sensitivity for identifying three-vessel disease in multi-vessel coronary artery lesions was better,at 82.9%.Conclusion:Acoustic analysis of turbulent murmur caused by coronary artery stenosis for diagnosis of CAD may have favorable performance in the Chinese population.This method has good performance in CA

关 键 词：Coronary artery disease coronary artery stenosis heart sounds non-invasive testing 

分 类 号：R543.3[医药卫生—心血管疾病]