Estimation of pulmonary artery pressure by spectral analysis of the second heart sound.

ABSTRACT

The objective of the present work was to test and validate a noninvasive method based on spectral analysis of the second heart sound (S2) to estimate the pulmonary artery (PA) systolic pressure in 89 patients with a bioprosthetic heart valve. The technique was compared with continuous-wave Doppler estimation of PA systolic pressure in these patients. The heart sounds recorded at the pulmonary area on the chest wall were digitized by computer. The spectra of S2 and those of the aortic (A2) and the pulmonary (P2) components of S2 were computed with a fast-Fourier transform. Seven features were extracted from these spectra. The statistical analysis performed with the Pearson linear correlation coefficient showed that the best estimation of PA systolic pressure obtained by spectral phonocardiography (r = 0.84, SEE +/- 5.6 mm Hg, p <0.0001) was provided by the following equation PA systolic pressure = 47 + 0.68 Fp - 4.4 Qp - 17 Fp/Fa - 0.15 Fs, where Fs and Fp are dominant frequencies associated with the maximal amplitude of the power spectra of S2 and P2, respectively, Qp is the quality of resonance of P2, and Fp/Fa is the ratio of the dominant frequencies of P2 and A2, respectively.