title: Respiratory sound energy and its distribution patterns following clinical improvement of congestive heart failure: a pilot study.
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.
authors.affiliation: Division of Critical Care Medicine, Robert Wood Johnson School of Medicine, Camden, NJ 08103, USA. wangzhen1369@hotmail.com
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.forename: Brigitte M
authors.initials: BM
authors.lastname: Baumann
authors.forename: Karen
authors.initials: K
authors.lastname: Slutsky
authors.forename: Karen N
authors.initials: KN
authors.lastname: Gruber
authors.forename: Smith
authors.initials: S
authors.lastname: Jean
mesh_terms: D000293:Adolescent; D000328:Adult; D001314:Auscultation / Q000295:instrumentation / Q000379:methods*; D016022:Case-Control Studies; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D004452:Echocardiography; D004636:Emergency Service, Hospital; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011654:Pulmonary Edema / Q000150:complications; D011859:Radiography; D012121:Respiration, Artificial; D012135:Respiratory Sounds / Q000503:physiopathology*; D012815:Signal Processing, Computer-Assisted; D013018:Sound Spectrography / Q000379:methods; D016896:Treatment Outcome; D014732:Vibration; D055815:Young Adult