Arterial pressure changes monitoring with a new precordial noninvasive sensor

BackgroundRecently, a cutaneous force-frequency relation recording system based on first heart sound amplitude vibrations has been validated. A further application is the assessment of Second Heart Sound (S2) amplitude variations at increasing heart rates. The aim of this study was to assess the relationship between second heart sound amplitude variations at increasing heart rates and hemodynamic changes.MethodsThe transcutaneous force sensor was positioned in the precordial region in 146 consecutive patients referred for exercise (n = 99), dipyridamole (n = 41), or pacing stress (n = 6). The curve of S2 peak amplitude variation as a function of heart rate was computed as the increment with respect to the resting value.ResultsA consistent S2 signal was obtained in all patients. Baseline S2 was 7.2 ± 3.3 mg, increasing to 12.7 ± 7.7 mg at peak stress. S2 percentage increase was + 133 ± 104% in the 99 exercise, + 2 ± 22% in the 41 dipyridamole, and + 31 ± 27% in the 6 pacing patients (p < 0.05). Significant determinants of S2 amplitude were blood pressure, heart rate, and cardiac index with best correlation (R = .57) for mean pressure.ConclusionS2 recording quantitatively documents systemic pressure changes.

[1]  P J Poppers,et al.  The effect of halothane on the amplitude and frequency characteristics of heart sounds in children. , 1999, Anesthesia and analgesia.

[2]  A. Luisada,et al.  New index of cardiac contractility during stress testing with treadmill. , 1986, Acta cardiologica.

[3]  C. Negrão,et al.  Previous exercise attenuates muscle sympathetic activity and increases blood flow during acute euglycemic hyperinsulinemia. , 2005, Journal of applied physiology.

[4]  T. Otsuki,et al.  Contribution of systemic arterial compliance and systemic vascular resistance to effective arterial elastance changes during exercise in humans , 2006, Acta physiologica.

[5]  T. Lanthier,et al.  Spectral analysis and acoustic transmission of mitral and aortic valve closure sounds in dogs. Part 1 Modelling the heart/thorax acoustic system , 1990, Medical and Biological Engineering and Computing.

[6]  Jose Luis Zamorano,et al.  Stress echocardiography expert consensus statement: European Association of Echocardiography (EAE) (a registered branch of the ESC). , 2008, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[7]  H. C. Hardy,et al.  Acoustic transmission characteristics of the thorax. , 1963, Journal of applied physiology.

[8]  Francesco Faita,et al.  Cardiac reflections and natural vibrations: Force-frequency relation recording system in the stress echo lab , 2007, Cardiovascular ultrasound.

[9]  R. Kusukawa,et al.  Hemodynamic determinants of the amplitude of the second heart sound. , 1966, Journal of applied physiology.

[10]  E. Picano,et al.  Noninvasive assessment of left ventricular contractility by pacemaker stress echocardiography. , 2003, European journal of heart failure.

[11]  Influence of the aortic component of the second heart sound on left ventricular maximal negative dP/dt in the dog. , 1985, The American journal of cardiology.

[12]  R M Rangayyan,et al.  Phonocardiogram signal analysis: a review. , 1987, Critical reviews in biomedical engineering.

[13]  T. Lanthier,et al.  Spectral analysis and acoustic transmission of mitral and aortic valve closure sounds in dogs , 1990, Medical and Biological Engineering and Computing.

[14]  Patricia A Pellikka,et al.  American Society of Echocardiography recommendations for performance, interpretation, and application of stress echocardiography. , 2007, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[15]  M. Piepoli,et al.  Persistent peripheral vasodilation and sympathetic activity in hypotension after maximal exercise. , 1993, Journal of applied physiology.

[16]  B. Franklin,et al.  Exercise and Hypertension , 2004 .

[17]  Vivek Nigam,et al.  A dynamic method to estimate the time split between the A2 and P2 components of the S2 heart sound , 2006, Physiological measurement.

[18]  M. Tavel,et al.  Spectral analysis of heart sounds: relationships between some physical characteristics and frequency spectra of first and second heart sounds in normals and hypertensives. , 1984, Journal of biomedical engineering.

[19]  M. Cerqueira,et al.  Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. , 2002, Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology.

[20]  E. Picano,et al.  Negative stress echo: further prognostic stratification with assessment of pressure-volume relation. , 2008, International journal of cardiology.

[21]  F. Khaja,et al.  Hemodynamic and anatomic determinants of relative differences in amplitude of the aortic and pulmonary components of the second heart sound. , 1978, The American journal of cardiology.

[22]  C R Thompson,et al.  Comparison of short-time Fourier, wavelet and time-domain analyses of intracardiac sounds. , 1993, Biomedical sciences instrumentation.

[23]  D. F. Santaella,et al.  Postexercise hypotension and hemodynamics: the role of exercise intensity. , 2004, The Journal of sports medicine and physical fitness.

[24]  D. Mion,et al.  Post-resistance exercise hypotension, hemodynamics, and heart rate variability: influence of exercise intensity , 2006, European Journal of Applied Physiology.

[25]  H N Sabbah,et al.  Exploration of the Cause of the Low Intensity Aortic Component of the Second Sound in Nonhypotensive Patients with Poor Ventricular Performance , 1978, Circulation.

[26]  Yuan-ting Zhang,et al.  Model-based Analysis of Effects of Systolic Blood Pressure on Frequency Characteristics of the Second Heart Sound , 2006, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.

[27]  S. M. Debbal,et al.  Automatic measure of the split in the second cardiac sound by using the wavelet transform technique , 2007, Comput. Biol. Medicine.

[28]  D. T. Barry,et al.  Quantification of first heart sound frequency dynamics across the human chest wall , 1994, Medical and Biological Engineering and Computing.

[29]  H N Sabbah,et al.  Investigation of the Theory and Mechanism of the Origin of the Second Heart Sound , 1976, Circulation research.

[30]  Francesco Faita,et al.  Diastolic time – frequency relation in the stress echo lab: filling timing and flow at different heart rates , 2008, Cardiovascular ultrasound.

[31]  David A. Kass,et al.  Effective Arterial Elastance as Index of Arterial Vascular Load in Humans , 1992, Circulation.

[32]  The influence of left ventricular relaxation in determination of the intensity of the aortic component of the second heart sound. , 1986, Japanese circulation journal.

[33]  J. Taylor,et al.  Impaired sympathetic vascular regulation in humans after acute dynamic exercise. , 1996, The Journal of physiology.