Simulation of Acute Pulmonary Hypertension in Beagle Dogs: Correlation Analysis Between Phonocardiogram and Right Ventricular Blood Pressure

Abstract

Acoustic cardiography (AC) combined with heart sound (HS) recording and electrocardiogram (ECG) provides a noninvasive and inexpensive way to understand the electrical mechanical activity of the heart. Pulmonary artery stenosis can cause hemodynamic abnormalities that might lead to pulmonary hypertension (PH). In this paper, we examined the relationships between the acoustic characteristics of the AC and hemodynamic changes in a beagle dog model of PH. Four healthy beagle dogs were injected with the prostaglandin endoperoxide receptor agonist U-44069 to induce acute PH states. AC was employed to analyze the process of pre-PH, intra-PH, and post-PH. Right ventricular blood pressure (RVBP) was measured via right cardiac catheterization, an invasive method performed in parallel for comparative hemodynamic evaluation. As RVBP increased or decreased, the HS features changed accordingly during acute PH occurrence and development. Right ventricular systolic blood pressure (RVSBP) significantly correlated with the minimum of the first HS (S1) amplitude (correlation coefficient (CC) = −0.82), energy of the S1 (CC = 0.86), energy of the second HS (S2) (CC = 0.67), entropy of the S1 (CC = −0.94), and ratio of electromechanical systolic time (EMST) to the cardiac cycle time (CC = 0.81). The two techniques (AC [HSs and ECG] versus right cardiac catheterization [RVBP]) were significantly correlated. Especially, the diastolic filling time (DFT) had a significant relationship with the right ventricular diastolic time (RVDT) (CC = 0.97), perfusion time (PT) (CC = 0.96), and cardiac cycle time (RR) (CC = 0.96). The CCs between the RVDT and the max dp/dt to min dp/dt, the EMST and the Q to min dp/dt, and the electromechanical activation time and the Q to max dp/dt were 0.95, 0.99, and 0.86, respectively. Furthermore, the logistic regression model with different combinations was used to identify the effective features for monitoring hemodynamic and pathophysiologic conditions. AC provided significant insight into mechanical dysfunction in a rapid and noninvasive way that could be used for early screening of PH.