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Respiratory sound energy and its distribution patterns following clinical improvement of congestive heart failure: a pilot study.

Wang Z, Baumann BM, Slutsky K, Gruber KN, Jean S - BMC Emerg Med (2010)

Bottom Line: Twenty-three consecutive CHF patients were imaged at the time of presentation to the emergency department and after clinical improvement.Geographical area of the images and respiratory sound patterns were quantitatively analyzed.Data from the CHF patients were also compared to healthy volunteers.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Critical Care Medicine, Robert Wood Johnson School of Medicine, Camden, NJ 08103, USA. wangzhen1369@hotmail.com

ABSTRACT

Background: Although congestive heart failure (CHF) patients typically present with abnormal auscultatory findings on lung examination, respiratory sounds are not normally subjected to additional analysis. The aim of this pilot study was to examine respiratory sound patterns of CHF patients using acoustic-based imaging technology. Lung vibration energy was examined during acute exacerbation and after clinical improvement.

Methods: Respiratory sounds throughout the respiratory cycle were captured using an acoustic-based imaging technique. Twenty-three consecutive CHF patients were imaged at the time of presentation to the emergency department and after clinical improvement. Digital images were created (a larger image represents more homogeneously distributed vibration energy of respiratory sound). Geographical area of the images and respiratory sound patterns were quantitatively analyzed. Data from the CHF patients were also compared to healthy volunteers.

Results: The median (interquartile range) geographical areas of the vibration energy image of acute CHF patients without and with radiographically evident pulmonary edema were 66.9 (9.0) and 64.1(9.0) kilo-pixels, respectively (p < 0.05). After clinical improvement, the geographical area of the vibration energy image of CHF patients without and with radiographically evident pulmonary edema were increased by 18 +/- 15% (p < 0.05) and 25 +/- 16% (p < 0.05), respectively.

Conclusions: With clinical improvement of acute CHF exacerbations, there was more homogenous distribution of lung vibration energy, as demonstrated by the increased geographical area of the vibration energy image.

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Vibration energy during maximal inspiration in acute CHF exacerbation patients without and with REPE on admission (Before) decreased after clinical improvement (After) (* = P < 0.05). Each color/line represents a patient. CHF, congestive heart failure. REPE, radiographically evident pulmonary edema.
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Figure 6: Vibration energy during maximal inspiration in acute CHF exacerbation patients without and with REPE on admission (Before) decreased after clinical improvement (After) (* = P < 0.05). Each color/line represents a patient. CHF, congestive heart failure. REPE, radiographically evident pulmonary edema.

Mentions: The median geographic area of each maximal inspiratory vibration energy image was calculated. In healthy volunteers, themedian (IQR) geographical area of the vibration energy image was 76.2 (6.0) kilo-pixels. On admission, areas for CHF patients without REPE and those with REPE were66.9 (9.0) and 64.1(9.0), respectively (p < 0.05) (Figure 3). On admission, the geographical area in CHF patients without and with REPE was significantly lower compared to the geographical area of healthy volunteers (p < 0.05). After clinical improvement, the geographic area increased to 71.9 (12.0) and 73.4 (12.0) kilo-pixels in patients without REPE and with pulmonary edema, respectively (Figure 4). This corresponded to increases in area of 18 ± 15% (p < 0.01) and 25 ± 16% (p < 0.01), in the without REPE and with REPE patients, respectively. The total vibration energy values were calculated in each group on admission and were found to be significantly higher in CHF patients with REPE compared to those without REPE and healthy volunteers (Figure 5) (p < 0.05 between edema group and others). Total vibration energy decreased in CHF patients with REPE following clinical improvement by an average of 90 ± 11% (p < 0.01) but remained unchanged in CHF patients without REPE (Figure 6).


Respiratory sound energy and its distribution patterns following clinical improvement of congestive heart failure: a pilot study.

Wang Z, Baumann BM, Slutsky K, Gruber KN, Jean S - BMC Emerg Med (2010)

Vibration energy during maximal inspiration in acute CHF exacerbation patients without and with REPE on admission (Before) decreased after clinical improvement (After) (* = P < 0.05). Each color/line represents a patient. CHF, congestive heart failure. REPE, radiographically evident pulmonary edema.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2821310&req=5

Figure 6: Vibration energy during maximal inspiration in acute CHF exacerbation patients without and with REPE on admission (Before) decreased after clinical improvement (After) (* = P < 0.05). Each color/line represents a patient. CHF, congestive heart failure. REPE, radiographically evident pulmonary edema.
Mentions: The median geographic area of each maximal inspiratory vibration energy image was calculated. In healthy volunteers, themedian (IQR) geographical area of the vibration energy image was 76.2 (6.0) kilo-pixels. On admission, areas for CHF patients without REPE and those with REPE were66.9 (9.0) and 64.1(9.0), respectively (p < 0.05) (Figure 3). On admission, the geographical area in CHF patients without and with REPE was significantly lower compared to the geographical area of healthy volunteers (p < 0.05). After clinical improvement, the geographic area increased to 71.9 (12.0) and 73.4 (12.0) kilo-pixels in patients without REPE and with pulmonary edema, respectively (Figure 4). This corresponded to increases in area of 18 ± 15% (p < 0.01) and 25 ± 16% (p < 0.01), in the without REPE and with REPE patients, respectively. The total vibration energy values were calculated in each group on admission and were found to be significantly higher in CHF patients with REPE compared to those without REPE and healthy volunteers (Figure 5) (p < 0.05 between edema group and others). Total vibration energy decreased in CHF patients with REPE following clinical improvement by an average of 90 ± 11% (p < 0.01) but remained unchanged in CHF patients without REPE (Figure 6).

Bottom Line: Twenty-three consecutive CHF patients were imaged at the time of presentation to the emergency department and after clinical improvement.Geographical area of the images and respiratory sound patterns were quantitatively analyzed.Data from the CHF patients were also compared to healthy volunteers.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Critical Care Medicine, Robert Wood Johnson School of Medicine, Camden, NJ 08103, USA. wangzhen1369@hotmail.com

ABSTRACT

Background: Although congestive heart failure (CHF) patients typically present with abnormal auscultatory findings on lung examination, respiratory sounds are not normally subjected to additional analysis. The aim of this pilot study was to examine respiratory sound patterns of CHF patients using acoustic-based imaging technology. Lung vibration energy was examined during acute exacerbation and after clinical improvement.

Methods: Respiratory sounds throughout the respiratory cycle were captured using an acoustic-based imaging technique. Twenty-three consecutive CHF patients were imaged at the time of presentation to the emergency department and after clinical improvement. Digital images were created (a larger image represents more homogeneously distributed vibration energy of respiratory sound). Geographical area of the images and respiratory sound patterns were quantitatively analyzed. Data from the CHF patients were also compared to healthy volunteers.

Results: The median (interquartile range) geographical areas of the vibration energy image of acute CHF patients without and with radiographically evident pulmonary edema were 66.9 (9.0) and 64.1(9.0) kilo-pixels, respectively (p < 0.05). After clinical improvement, the geographical area of the vibration energy image of CHF patients without and with radiographically evident pulmonary edema were increased by 18 +/- 15% (p < 0.05) and 25 +/- 16% (p < 0.05), respectively.

Conclusions: With clinical improvement of acute CHF exacerbations, there was more homogenous distribution of lung vibration energy, as demonstrated by the increased geographical area of the vibration energy image.

Show MeSH
Related in: MedlinePlus