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Harnessing the value of cardiac biomarkers

The CORE 500™ Digital Stethoscope captures both EMAT and S3/S4 sounds – cardiac acoustic biomarkers that have demonstrated utility in helping to identify heart function deterioration.1,2 

What is EMAT?

What is EMAT?

EMAT measures the systolic interval from the Q-wave onset to the S1 peak, which is then normalized to heart rate, requiring simultaneous ECG recording and auscultation.3

Why EMAT Matters:

  • Association with left ventricular (LV) function: Prolonged %EMAT values are linked to impaired LV contractility3-6
  • Predicting major adverse cardiac events (MACE): Prolonged %EMAT may indicate decompensation and predict MACE.1,3,7-11
  • Enhanced management: EMAT-guided management may be more effective than traditional symptom-based approaches, potentially improving patient outcomes.1,12
What is EMAT?

Why device-measured S3/S4 sounds?

Some clinically significant cardiac sounds can be difficult to detect with conventional analogue stethoscopes14,15. The CORE 500™ amplifies cardiac sounds which can enhance detection of S3/S4 sounds,2,15-20 cardiac biomarkers for evaluating heart failure progression, and provide a more detailed picture of cardiac health.1,6,11,13,21-34

Clinical relevance:

  • S3 sounds: Indicative of elevated LV filling pressure, reduced ejection fraction, and correlate with increased BNP levels – signs predictive of cardiac mortality. 1,13,22,35
  • S4 sounds: Reflect abnormalities in ventricular filling, and changes in these sounds may signal impeding  MACE.23,29,34

References

  1. Butler J, et al. ESC Heart Failure. 2024. doi: https://doi.org/10.1002/ehf2.15075.
  2. Eko CORE 500 FAQ. Available at: https://support.ekohealth.com/hc/en-us/articles/16698084427547-CORE-500-FAQ [accessed September 2024].
  3. Efstratiadis S, Michaels AD. J Card Fail. 2008;14:577–82. doi: 10.1016/j.cardfail.2008.03.011.
  4. Roos M, et al. Congest Heart Fail. 2006;12 Suppl 1:19–24. doi: 10.1111/j.1527-5299.2006.05769.x.
  5. Roos M, et al. J Card Fail. 2008;14:310–9. doi: 10.1016/j.cardfail.2007.12.004.
  6. Wang S, et al. Int J Cardiol. 2013;168:1881–6. doi: 10.1016/j.ijcard.2012.12.064.
  7. Kosmicki DL, et al. Congest Heart Fail. 2010;16:249–53. doi: 10.1111/j.1751-7133.2010.00191.x.
  8. Chao TF, et al. Intern Med. 2010;49:2031–7. doi: 10.2169/internalmedicine.49.3944.
  9.  Zhang J, et al. Cardiovasc Ther. 2020;2020:4532596. doi: 10.1155/2020/4532596.
  10. Zhang J, Liu W. Pak J Med Sci. 2022;38(3Part-I):456-461. doi: 10.12669/pjms.38.3.4500.
  11. Wang S, et al. Int J Cardiol. 2013;168:1881–6. doi: 10.1016/j.ijcard.2012.12.064.
  12. Sung SH, et al. J Card Fail. 2020;26:142–50. doi: 10.1016/j.cardfail.2019.09.012.
  13. Wang S, et al. Int J Cardiol. 2016;219:121–6. doi: 10.1016/j.ijcard.2016.06.004.
  14. Tokodi M, Kovács A. Eur Heart J Digit Health. 2022;4:1–3. doi: 10.1093/ehjdh/ztac075.
  15. Eko EAS 510(k) Submission.
  16. Dwivedi A, et al. IEEE Access. 2019;7:8316–45. 10.1109/ACCESS.2018.2889437.
  17. Debbal S & Bereksi Reguig F. IJBSCHS. 2008;13:85–90.
  18. Spencer CS, Pennington K. Online J Issues Nurs. 2015;20:6.
  19. Nivitha Varghees V, Ramachandran KI. Biomedical Signal Processing and Control. 2014;13:174–188. 10.1016/j.bspc.2014.05.002.
  20. Leng S, et al. BioMedical Engineering OnLine. 2015;14:66. doi:10.1186/s12938-015-0056-y.
  21. Shono A, et al. Intern Med. 2019;58:2535–8. doi: 10.2169/internalmedicine.2731-19.
  22. Wen YN, et al. Int J Cardiol. 2014;172:548–60. doi: 10.1016/j.ijcard.2013.12.298.
  23. Williams ES. The Fourth Heart Sound. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 25. Available from: https://www.ncbi.nlm.nih.gov/books/NBK344/ [accessed September 2024].
  24. Gardner RS, et al. ESC Heart Fail. 2021;8:1571–81. doi: 10.1002/ehf2.13261.
  25. Calò L, et al. J Interv Card Electrophysiol. 2020;58:95–101. doi: 10.1007/s10840-019-00668-y.
  26. Siejko KZ, et al. Pacing Clin Electrophysiol. 2013;36:334–46. doi: 10.1111/pace.12059.
  27. Dao L, et al. Front Cardiovasc Med. 2022;9:918051. doi: 10.3389/fcvm.2022.918051.
  28. Selvaraj S, et al. Circulation. 2019;140:1369–79. doi: 10.1161/CIRCULATIONAHA.119.039920.
  29. Chang CC, et al. ESC Heart Fail. 2015;2:184–93. doi: 10.1002/ehf2.12044.
  30. Gurjão F, et al. The presence of the third heart sound as a predictor of mortality in patients with heart failure in a referral hospital in the north of Ceará. World Congress of Cardiology/Brazilian Congress of Cardiology 2022; Rio de Janeiro, Brazil.
  31. Jering K, et al. JACC Heart Fail. 2021;9:386–97. doi: 10.1016/j.jchf.2021.01.011.
  32. Negi S, et al. PLoS One. 2014;9:e96325. doi: 10.1371/journal.pone.0096325.
  33. Minami Y, et al. Int J Clin Pract. 2015;69:820–8. doi: 10.1111/ijcp.12603.
  34. Sakai C, et al. Ann Noninvasive Electrocardiol. 2022;27:e12932. doi: 10.1111/anec.12932.
  35. Marcus GM, et al. JAMA. 2005;293:2238–44. doi: 10.1001/jama.293.18.2238.