Vocal Biomarker Is Associated With Hospitalization and Mortality Among Heart Failure Patients. Issue 7 (9th April 2020)

• Record Type: Journal Article
• Authors: Maor, Elad; Perry, Daniella; Mevorach, Dana; Taiblum, Nimrod; Luz, Yotam; Mazin, Israel; Lerman, Amir; Koren, Gideon; Shalev, Varda
• Is Part Of: Journal of the American Heart Association. Volume 9:Issue 7(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-04-09
• Subjects: congestive heart failure -- telemedicine -- vocal biomarkers -- voice; Heart -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cerebrovascular disease -- Periodicals; Cardiology -- Periodicals; 616.1
• DOI: 10.1161/JAHA.119.013359
• Languages: English
• ISSNs: 2047-9980

Abstract

Abstract : Background: The purpose of this article is to evaluate the association of voice signal analysis with adverse outcome among patients with congestive heart failure (CHF). Methods and Results: The study cohort included 10 583 patients who were registered to a call center of patients who had chronic conditions including CHF in Israel between 2013 and 2018. A total of 223 acoustic features were extracted from 20 s of speech for each patient. A biomarker was developed based on a training cohort of non‐CHF patients (N=8316). The biomarker was tested on a mutually exclusive CHF study cohort (N=2267) and was evaluated as a continuous and ordinal (4 quartiles) variable. Median age of the CHF study population was 77 (interquartile range 68–83) and 63% were men. During a median follow‐up of 20 months (interquartile range 9–34), 824 (36%) patients died. Kaplan–Meier survival analysis showed higher cumulative probability of death with increasing quartiles (23%, 29%, 38%, and 54%; P <0.001). Survival analysis with adjustment to known predictors of poor survival demonstrated that each SD increase in the biomarker was associated with a significant 32% increased risk of death during follow‐up (95% CI, 1.24–1.41, P <0.001) and that compared with the lowest quartile, patients in the highest quartile were 96% more likely to die (95% CI, 1.59–2.42, P <0.001). The model consistently demonstrated an independent association of the biomarker with hospitalizations during follow‐up ( P <0.001). Conclusions: Noninvasive vocal biomarker is associated with adverse outcome among CHF patients, suggesting a possible role for voice analysis in telemedicine and CHF patient care.