000			03807nam a22005177a 4500
008			130807s20132013 xxu||||| |||| 00| 0 eng d
022			_a0002-9149
040			_aOvid MEDLINE(R)
099			_a23290309
245			_aUtility of an advanced digital electronic stethoscope in the diagnosis of coronary artery disease compared with coronary computed tomographic angiography.
251			_aAmerican Journal of Cardiology. 111(6):786-92, 2013 Mar 15.
252			_aAm J Cardiol. 111(6):786-92, 2013 Mar 15.
253			_aThe American journal of cardiology
260			_c2013
266			_d2013-09-17
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aThe detection of coronary artery microbruits, subaudible bruits too faint to be heard through standard auscultation, may provide an alternative means to diagnose coronary artery disease (CAD). The aim of this study was to test the accuracy of a novel digital electronic stethoscope, the Cardiac Sonospectrographic Analyzer (CSA; SonoMedica model 3.0, SonoMedica, Inc., Vienna, Virginia, United States Food and Drug Administration 510[k] cleared) to diagnose CAD compared to gold-standard diagnosis using cardiac computed tomographic (CT) angiography. In this blinded, single-site study, adults previously referred for CT imaging were selected. Patients underwent CT and CSA evaluations. CSA exams entailed recording heart sounds at 9 positions on the chest for 40 seconds at each position. An algorithm then processed these data to generate a microbruit score. The CT scans were read blinded to patients' microbruit scores. Sensitivity and specificity of the CSA in detecting CAD compared to CT imaging were estimated using standard receiver-operating characteristic curves calculated from logistic regression models. A total of 161 patients, aged 57 +/- 13years(range 22 to 85), 53% with hypertension and 40% with obesity (body mass index>=30kg/m(2)), completed the protocol and had evaluable CT and CSA examinations. The overall sensitivity of the CSA to identify >50% stenosis in any major epicardial coronary artery as determined by CT imaging was 89.5% (p <0.0001). Gender-specific models based on smaller sample sizes had slightly poorer results and lower specificity among men with heavy chest hair. In conclusion, the CSA showed high sensitivity and specificity for the detection of significant early CAD in an outpatient setting and represents a new noninvasive device for detecting abnormal coronary blood flow as occurs in CAD. Copyright 2013 Elsevier Inc. All rights reserved.
546			_aEnglish
650			_a*Coronary Angiography
650			_a*Coronary Artery Disease/di [Diagnosis]
650			_a*Stethoscopes
650			_a*Tomography, X-Ray Computed
650			_aAdult
650			_aAged
650			_aAged, 80 and over
650			_aAlgorithms
650			_aCoronary Artery Disease/ra [Radiography]
650			_aFemale
650			_aHirsutism/co [Complications]
650			_aHumans
650			_aHypertension/co [Complications]
650			_aLogistic Models
650			_aMale
650			_aMiddle Aged
650			_aObesity/co [Complications]
650			_aProspective Studies
650			_aSensitivity and Specificity
651			_aMedStar Heart & Vascular Institute
657			_aComparative Study
657			_aJournal Article
657			_aResearch Support, Non-U.S. Gov't
700			_aTaylor, Allen J
790			_aFiggatt A, Kushner H, Makaryus AN, Makaryus JN, Mieres J, Mulholland D, Semmlow JL, Taylor AJ
856			_uhttp://dx.doi.org/10.1016/j.amjcard.2012.11.039 _zhttp://dx.doi.org/10.1016/j.amjcard.2012.11.039
942			_cART _dArticle
999			_c1376 _d1376