Acoustic Cardiography in Heart Failure Assessment

Acoustic cardiography integrates phonocardiography with electrocardiography to capture both mechanical vibrations and electrical activity of the heart in a single non-invasive recording. By analysing the timing and intensity of heart sounds alongside electrocardiographic markers, it quantifies parameters such as electromechanical activation time, systolic dysfunction index and ventricular systolic time. This hybrid technique complements conventional echocardiography and biochemical assays by providing rapid, bedside assessment of left ventricular function and filling pressures. Recent advances in sensor miniaturisation, signal processing and mobile platforms have extended its use into home monitoring and telemedicine, enabling early detection of decompensation, personalisation of therapy and reduction of hospital readmissions. Its simplicity, cost-effectiveness and capacity for continuous monitoring position acoustic cardiography as a valuable tool in global heart failure management and research.

Research from Nature Portfolio

Recent investigations have evaluated acoustic cardiography parameters in specific patient populations. One study examined patients 72 hours after percutaneous coronary intervention for myocardial infarction and identified electromechanical activation time corrected for cardiac cycle length as a strong predictor of early ventricular remodelling. Abnormal values of the fourth heart sound intensity and the systolic dysfunction index further discriminated those at risk, with a corrected activation threshold demonstrating high sensitivity and specificity for detecting ensuing systolic impairment. Another analysis in haemodialysis patients focused on changes in acoustic markers before and after dialysis sessions. Increases in the systolic dysfunction index and electromechanical activation time, coupled with reductions in left ventricular systolic time, correlated independently with overall and cardiovascular mortality over follow-up, highlighting prognostic value in chronic heart failure populations.

Acoustic Cardiography in Heart Failure Assessment publication trend

The graph below shows the total number of articles in acoustic cardiography in heart failure assessment across all publications each year (not limited to Nature Index journals).

Technical terms

Acoustic cardiography: A hybrid technique combining heart sound recording with electrocardiography to assess cardiac function non-invasively.

Electromechanical activation time (EMAT): The interval from the onset of the QRS complex to the first heart sound, indicating excitation–contraction coupling.

Systolic dysfunction index (SDI): A composite score derived from multiple acoustic and electrical parameters to gauge left ventricular systolic performance.

Left ventricular systolic time (LVST): The duration between the first and second heart sounds, reflecting overlap of mechanical contraction and ejection phases.

Third (S3) and fourth (S4) heart sounds: Low-frequency vibrations associated with rapid filling (S3) and atrial contraction (S4), indicative of diastolic abnormalities.

Ejection fraction (EF): The percentage of blood volume ejected from the left ventricle per heartbeat, a standard measure of systolic function.

References

1. Beyond auscultation - acoustic cardiography in the diagnosis and assessment of cardiac disease. Swiss Medical Weekly (2008).
2. Predictive value of acoustic cardiography for post-PCI early ventricular remodeling in acute myocardial infarction. Scientific Reports (2023).
3. Changes in acoustic cardiographic parameters before and after hemodialysis are associated with overall and cardiovascular mortality in hemodialysis patients. Scientific Reports (2021).
4. A Wearable Multi-Sensor Array Enables the Recording of Heart Sounds in Homecare. Sensors (2023).
5. Accurate Modeling of Ejection Fraction and Stroke Volume With Mobile Phone Auscultation: Prospective Case-Control Study. JMIR Cardio (2024).
6. Mobile Cardiac Acoustic Monitoring System to Evaluate Left Ventricular Systolic Function in Pacemaker Patients. Journal of Clinical Medicine (2022).