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AuthorWinther, Simon
AuthorSchmidt, Samuel Emil
AuthorHolm, Niels Ramsing
AuthorToft, Egon
AuthorStruijk, Johannes Jan
AuthorBøtker, Hans Erik
AuthorBøttcher, Morten
Available date2016-11-06T09:32:40Z
Publication Date2016-02
Publication NameThe International Journal of Cardiovascular Imagingen_US
Identifierhttp://dx.doi.org/10.1007/s10554-015-0753-4
CitationWinther S, Schmidt SE, Holm NR, et al. Diagnosing coronary artery disease by sound analysis from coronary stenosis induced turbulent blood flow: diagnostic performance in patients with stable angina pectoris. The International Journal of Cardiovascular Imaging. 2016;32:235-245.
ISSN1569-5794
URIhttp://hdl.handle.net/10576/4973
AbstractOptimizing risk assessment may reduce use of advanced diagnostic testing in patients with symptoms suggestive of stable coronary artery disease (CAD). Detection of diastolic murmurs from post-stenotic coronary turbulence with an acoustic sensor placed on the chest wall can serve as an easy, safe, and low-cost supplement to assist in the diagnosis of CAD. The aim of this study was to evaluate the diagnostic accuracy of an acoustic test (CAD-score) to detect CAD and compare it to clinical risk stratification and coronary artery calcium score (CACS). We prospectively enrolled patients with symptoms of CAD referred to either coronary computed tomography or invasive coronary angiography (ICA). All patients were tested with the CAD-score system. Obstructive CAD was defined as more than 50 % diameter stenosis diagnosed by quantitative analysis of the ICA. In total, 255 patients were included and obstructive CAD was diagnosed in 63 patients (28 %). Diagnostic accuracy evaluated by receiver operating characteristic curves was 72 % for the CAD-score, which was similar to the Diamond–Forrester clinical risk stratification score, 79 % (p = 0.12), but lower than CACS, 86 % (p < 0.01). Combining the CAD-score and Diamond–Forrester score, AUC increased to 82 %, which was significantly higher than the standalone CAD-score (p < 0.01) and Diamond–Forrester score (p < 0.05). Addition of the CAD-score to the Diamond–Forrester score increased correct reclassification, categorical net-reclassification index = 0.31 (p < 0.01). This study demonstrates the potential use of an acoustic system to identify CAD. The combination of clinical risk scores and an acoustic test seems to optimize patient selection for diagnostic investigation.
SponsorDanish National Business Innovation Fund and Acarix A/S.
Languageen
PublisherSpringer Netherlands / Society for Cardiovascular Imaging
SubjectCoronary artery disease
SubjectAngina pectoris
SubjectHeart sounds
SubjectSensitivity and specificity
SubjectCardiovascular diagnostic technic
TitleDiagnosing coronary artery disease by sound analysis from coronary stenosis induced turbulent blood flow: diagnostic performance in patients with stable angina pectoris
TypeArticle
Pagination235-245
Issue Number2
Volume Number32
dc.identifier.essn 1573-0743


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