Prognostic value of acoustic cardiography in patients with chronic heart failure.

BACKGROUND: Rapid risk stratification in patients with heart failure is critically important but challenging. The aim of our study is to ascertain whether acoustic cardiography can identify heart failure (HF) patients at high risk for mortality. METHODS: A total of 474 HF patients were enrolled into our study (76±11years old). Acoustic cardiographic parameters included S3 score (ie, third heart sound exists) and systolic dysfunction index (SDI) (correlated closely with left ventricular systolic dysfunction). The event-free survival curves were plotted by Kaplan-Meier method. Cox regression analysis was used to identify independent predictors for all-cause mortality. RESULTS: During a mean follow-up of 484days, 169 (35.7%) patients died and 126 (26.6%) were due to cardiac causes. After controlling for age, systolic blood pressure, hemoglobin, blood urea nitrogen, albumin, as well as ACEI and beta-blocker treatment in multivariate Cox regression analysis, SDI ≥5 and S3 score ≥4 were both independent predictors for all-cause mortality. Kaplan-Meier analysis showed that HF patients with SDI ≥5 or S3 score ≥4 had a significantly lower survival (52.2% vs. 69.2%, Log-rank χ(2)=18.07, P<0.001; 56.8% vs. 68.6%, Log-rank χ(2)=10.58, P=0.001, respectively) than those with lower SDI or S3 score. CONCLUSIONS: Acoustic cardiography could serve as a cost-effective and time-efficient tool to identify HF patients at high risk for mortality who might benefit from aggressive monitoring and intervention. It may improve assessment and initial disposition decisions in HF management.