Diagnosis of Coronary Artery Disease by Acoustic Analysis of Turbulent Murmur Caused by Coronary Artery Stenosis: A Single Center Study from China

Aim: Intracoronary murmur results from turbulent flow due to coronary artery narrowing. This study evaluated the diagnostic performance of a method for acoustic analysis of turbulent murmur caused by coronary artery stenosis in coronary artery disease (CAD) in Chinese populations.Method: Patients admitted to the cardiovascular department of the Sixth Medical Center of the Chinese People’s Liberation Army General Hospital between September 2021 and June 2022 for elective coronary angiography were prospectively enrolled. A digital electronic stethoscope was used to record heart sounds before angiography. Quantitative coronary angiography (QCA) served as the “gold standard” for CAD diagnosis to evaluate the diagnostic performance of the acoustic analysis method for CAD.Results: A total of 452 patients had complete QCA and heart sound data. The final interpretation results of the acoustic analysis method indicated 310 disease cases and 142 normal results. Increasing the cut-off values of coronary artery diameter stenosis from 30% to 50%, 70%, and 90% increased the sensitivity and NPV of the acoustic analysis method; the sensitivity was 75.6%, 81.9%, 83.3%, and 85.7%, respectively; the NPV was 33.1%, 57.0%, 69.7%, and 88.0%, respectively; the specificity and PPV decreased (specificity of 75.8%, 70.4%, 51.0%, and 37.5%, respectively; PPV of 95.2%, 89.0%, 69.4%, and 32.9%, respectively); and the AUC values were 0.757, 0.762, 0.672, and 0.616, respectively. The sensitivity of the acoustic analysis method for one-vessel disease was 86.6% when the cut-off value was 50%. The sensitivity for identifying left anterior descending coronary artery lesions was best, at 90.7%. The sensitivity for identifying isolated coronary artery branch lesions was 66.7%, whereas the sensitivity for identifying three-vessel disease in multi-vessel coronary artery lesions was better, at 82.9%.Conclusion: Acoustic analysis of turbulent murmur caused by coronary artery stenosis for diagnosis of CAD may have favorable performance in the Chinese population. This method has good performance in CAD diagnosis with a cut-off coronary artery diameter for stenosis of 50%

Design of the phonocardiography appliance for coronary artery disease diagnosing and monitoring : business perspectives analysis of innovative medical technologies for cardiovascular diseases in Finland

The topic of this study is the application of modern medical technology to cardiovascular conditions. The main purpose of that research is to evaluate myocardium disorders from the versatile perspectives and propose the design of a socially-demanding and financially-efficient technological solution targeted to coronary artery disease (CAD) diagnosing and monitoring. Phonocardiography and audial CAD detection are discussed as innovative methods for personalized healthcare applications and based on that, digital product design is developed in the form of functional specification, wearable device model, iOS and WatchOS applications interface architecture. In addition to the diseases study, myocardium signals acquisition discussion and to device design itself, market research is conducted. It is focused on medical technologies segment in general and cardiological systems in particular. Finland and Nordic Europe are the major covered regions, while global trends are outlined to collect the vision on the general market tendency. Core assessment topics are medical technology product distribution models, investment potential and development barriers. The final result could be used as a foundation for further product development and as an overview or guidelines for businesses interested in healthcare Internet-of-Things and cardiological systems