Predictive value of acoustic cardiogram for early-stage ventricular remodeling after acute myocardial infarction: an analysis of 102 cases

Abstract

Objective To investigate the predictive value of acoustic cardiographic parameters for post-acute myocardial infarction (AMI) early ventricular remodeling (EVR). Methods A total of 102 AMI patients undergoing percutaneous coronary intervention (PCI) in our hospital during June 2021 and February 2022 were recruited in this study. Electrocardiography, cardiac Doppler ultrasound examination, and acoustic cardiography were performed for all of them. Their biomarkers of cardiac injury and brain natriuretic peptide (BNP) were detected and recorded. According to the value of left ventricular ejection fraction (LVEF), they were and divided into EVR group (< 50%, n=50) and control group (≥50%, n=52). The baseline data and acoustic cardiographic parameters were compared between the 2 groups. Multivariate logistic regression analysis was applied to analyze the independent predictors for EVR, and the area under the curve (AUC) of receiver operating characteristic (ROC) were conducted to evaluate the predictive performances of these predictive factors. Results Among the acoustic cardiographic parameters, significantly higher electromechanical activation time divided by the cardiac cycle length (EMATc), left ventricular systolic time divided by the cardiac cycle length (LVSTc), fourth heart sound (S4) strength, and systolic dysfunction index (SDI) were observed in the EVR group than the control group (P<0.05). And in the clinical data and acoustic cardiographic parameters, male (OR=53.20, 95%CI: 3.80~1 349.00, P=0.007), EMATc (OR=2.62, 95%CI: 1.77~4.30, P<0.001) and LVEDD (OR=1.19, 95%CI: 1.03~1.42, P=0.029) finally entered in the logistic regression model in a logistic regression model predicting EVR. EMATc level could satisfactorily distinguish those patients with EVR (AUC=0.892, 95%CI: 0.834~0.949, P<0.001), and when the cut-off point was set as 11.50, the sensitivity could be up to 76.0%. LVEDD level at an optimal cut-off value of 49.50 mm yielded a specificity of 86.5%, providing evidence for an exclusion diagnosis. Conclusion Acoustic cardiographic parameter EMATc is an independent predictor for EVR in AMI patients.

Keywords

• acute myocardial infarction
• early ventricular remodeling
• acoustic cardiography
• prediction ability
• ematc