Comparison of Cardiac Output Measured by Phonocardiography and Transthoracic Echocardiography in Patients with Valvular Disease and Congenital Heart Anomalies

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Anesthesiology and Critical Care, School of Medicine AND Anesthesiology and Critical Care Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Digital Signal Processing Research Lab, School of Electrical and Computer Engineering, Najafabad Branch, Islamic Azad University, Isfahan, Iran

3 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The aim of this study was to compare cardiac output (CO) between two methods of phonocardiography and transthoracic echocardiography in patients with valvular disease and congenital heart anomalies.Methods: Seventy one patients (39 males and 32 females) ranging from 5 days to 13 years (mean: 22.5 months) were enrolled in the study and CO was obtained using transthoracic echocardiography. Afterwards, their heart sounds were recorded using an electronic stethoscope and analyzed to calculate CO and ejection fraction (EF). These amounts were compared to each other using statistical tests.Findings: The mean CO reported by transthoracic echocardiography and phonocardiography was reported 4.62 (SD = 0.98) and 4.55 (SD = 0.96), respectively. Comparison of these values between two methods showed that CO amounts are both significantly higher from transthoracic echocardiography (P < 0.05). Pearson correlation analysis showed a statistically significant correlation between CO among two methods (Pearson coefficient: 0.99 and 0.74 respectively; P < 0.05).Conclusion: This study showed that phonocardiography cannot be an exact alternative for transthoracic echocardiography to report CO; however, considering the significant correlation between these amounts, it can give us an acceptable estimation of heart condition by CO and should be used cautiously

Keywords


  1. David LR, Mittnacht JCA, Manecke GR, Kaplan JA. Monitoring of the heart and vascular system. In: Kaplan JA, Reich DL, Konstadt SN, editors. Kaplan's cardiac anesthesia: Expert consult premium. 6th ed. Amsterdam, Netherlands: Elsevier Health Sciences; 2011. p. 416-50.
  2. Lavdaniti M. Invasive and non-invasive methods for cardiac output measurement. International Journal of Caring Sciences 2008; 1(3): 112-7.
  3. Mark JB, Steinbrook RA, Gugino LD, Maddi R, Hartwell B, Shemin R, et al. Continuous noninvasive monitoring of cardiac output with esophageal Doppler ultrasound during cardiac surgery. Anesth Analg 1986; 65(10): 1013-20.
  4. Abbas AK, Bassam R. Phonocardiography signal processing. Morgan and Claypool Publishers; 2009.
  5. Hsieh BP, Unver K, McNulty E, Schiller NB. The amplitude ratio of the first to second heart sound is reduced in left ventricular systolic dysfunction. Int J Cardiol 2010; 145(1): 133-5.
  6. Bergman ST, Blomqvist CG. Amplitude of the first heart sound at rest and during exercise in normal subjects and in patients with coronary heart disease. Am Heart J 1975; 90(6): 714-20.
  7. Frome EL, Frederickson EL. Digital spectrum analysis of the first and second heart sounds- Comput Biomed Res 1974; 7(5): 421-31.
  8. Garrard CL, Weissler AM, Dodge HT. The relationship of alterations in systolic time intervals to ejection fraction in patients with cardiac disease. Circulation 1970; 42(3): 455-62.
  9. Saghafi MA, Amir Fattahi R, Mansouri M, Kazemi M. Automatic separation of S2, S1 heart sounds using wavelet transformation. Majlesi Journal of Electrical Engineering 2009; 3(1): 61-7. ]In Persian[.
  10. Hansen PB, Luisada AA, Miletich DJ, Albrecht RF. Phonocardiography as a monitor of cardiac performance during anesthesia. Anesth Analg 1989; 68(3): 385-7.
  11. Khoshpour Z, Mansouri M. Evaluation of the relationship of cardiac output measured by echocardiography and phonocardiography. Isfahan, Iran: Isfahan University of Medical Sciences; 2002. [In Persian].