Listening to heart sounds through the pressure waveform

Abstract

Abstract Non-invasive diagnostic modalities are integral to cardiovascular care; however, current systems primarily measure peripheral pressure, limiting the breadth of cardiovascular prognostication. We report a novel approach for extracting left side heart sounds using a brachial cuff device. The technique leverages brachial cuff device enhanced signal resolution to capture pressure fluctuations generated by cardiohemic system vibrations, the sound pressure waveform. We analyze left heart catheterization data alongside simultaneous brachial cuff device measurements to correlate sound pressure waveform features with left ventricle (LV) contractility. The extracted sound pressure waveform reveals two prominent oscillatory wave packets, termed WP1 and WP2, originating from cardiac structure vibrations associated with LV contractions and relaxation. We demonstrate that WP1 originates from LV contraction during systolic blood ejection through the aortic valve (AV) and is correlated with LV isovolumetric contraction, clinically measured by LV dPdt-max (Pearson-R = 0.65, p < 0.001). Additionally, we show that WP2 comes from LV elongation required for blood flow deceleration at the end of systole, causing AV closure, and is correlated with LV isovolumetric relaxation, measured by LV ndPdt-max (Pearson-R = 0.55, p < 0.001). These findings highlight the value of cuff sound pressure waveforms in providing insights about dynamic coupling of the LV-Aorta complex for non-invasive assessment of LV contractility.

Keywords

• Brachial cuff
• Heart sounds
• Sound pressure waveform
• Left ventricular contractility