Abstract: Background　Early assessment and prompt treatment for heart failure patients can prevent the occurrence of cardiac adverse events. Effective diagnostic tools are particularly crucial for these patients. Acoustic Cardiography（ACG），as an efficient and non-invasive bedside screening tool，can be used to evaluate the severity of heart failure. Objective　To investigate the feasibility of using a wearable acoustic-electrocardiographic remote monitoring device for dynamic cardiac function assessment during heart failure treatment. Methods　This prospective single-arm self-controlled study randomly enrolled 60 patients with acute heart failure admitted to the Department of Cardiology，First Affiliated Hospital of Kunming Medical University，from October 2020 to December 2020. Key parameters，including electro-mechanical activation time（EMAT），EMAT percentage（EMAT%），N-terminal pro-B-type natriuretic peptide（NT-proBNP），and body weight，were measured on admission days 1，2，3，5，and discharge day. Echocardiographic parameters were assessed on admission and discharge days. Trends in parameter changes and consistency among indicators were analyzed. Results　Among the 60 patients（35 males，25 females），the average hospitalization duration was 7.9 ± 3.2 days. One-way repeated measures ANOVA revealed statistically significant differences in EMAT，EMAT%，NT-proBNP，and body weight across time points（FEMAT=6.978，P<0.01；FEMAT%=3.108，P<0.05；FNT-proBNP=8.678，P<0.01；Fweight=27.246，P<0.01）. Pairwise comparisons demonstrated sequential decreases in these parameters from admission to discharge（P<0.01）. No significant differences were observed in echocardiographic parameters before and after treatment（P>0.05）. Time-adjusted repeated measures ANOVA confirmed consistent trends between EMAT and NT-proBNP changes during hospitalization（Day 1：β=67.724，P<0.01；Day 2：β=56.876，P<0.01；Day 3：β=38.503，P<0.01；Day 5：β=23.969，P<0.01；discharge：β=16.851，P<0.05）. Conclusion　Compared to bedside echocardiography（e.g.，LVEF）and NT-proBNP testing，the wearable acoustic-electrocardiographic remote monitoring device offers non-invasive，convenient，and cost-effective advantages. The device captures dynamic changes in acoustic and electrocardiographic parameters that correlate with clinical improvements in heart failure patients，suggesting its potential for remote cardiac function monitoring and timely detection of disease progression.

Key words: Heart failure, Heart sound electrocardiogram, Electromechanical activation time, Wearable devices

摘要： 背景　对于心力衰竭患者尽早评估病情并尽快给予治疗，可预防心脏不良事件的发生，有效的诊断评估工具对于此类患者尤其重要，心音描记技术（ACG）作为一种高效且无创的床旁筛查工具可用于判断心力衰竭患者的病情严重程度。目的　探究可穿戴式心音心电远程监测设备在心力衰竭治疗过程中用于动态监测评估心脏功能的可行性。方法　本研究为前瞻性单臂自身对照研究，采用随机抽样法选取2020年10—12月于昆明医科大学第一附属医院心内科住院治疗的急性心力衰竭患者60例，于入院第1天、第2天、第3天、第5天及出院当天测量患者心音心电指标包括机电激活时间百分比（EMAT%）以及氨基末端脑钠肽前体（NT-proBNP）、体重；于出入院当天测量患者心脏彩超指标，分析各指标随治疗情况改变的趋势及指标间变化的一致性。结果　入选60例患者，其中男性35例，女性25例，平均住院天数（7.9±3.2）d。单组重复测量方差分析结果显示不同时间点的EMAT、EMAT%、NT-proBNP、体重比较，差异均具有统计学意义（FEMAT=6.978，P<0.01；FEMAT%=3.108，P<0.05；FNT-proBNP=8.678，P<0.01；F体重=27.246，P<0.01），组内两两比较结果显示，EMAT、EMAT%、NT-proBNP、体重在入院当天、入院第2天、第3天、第5天及出院当天测量的5个时间点均依次降低（P<0.01）。研究对象出院前后心脏彩超各项指标比较，差异无统计学意义（P>0.05）。以时间校正重复测量方差分析检验EMAT与NT-proBNP变化是否一致，结果显示在该60例心衰住院患者中，EMAT与NT-proBNP变化一致（入院第1天β=67.724，P<0.01；入院第2天β=56.876，P<0.01；入院第3天β=38.503，P<0.01；入院第5天β=23.969，P<0.01；出院当天β=16.851，P<0.05），随病情好转而改变，差异具有统计学意义（P<0.05）。结论　可穿戴式心音心电远程监测设备与床旁心脏彩超测量LVEF以及检测NT-proBNP等项目相比，具备无创、便捷、经济等特点，所采集的心音、心电学参数可随心衰患者病情变化而改变，该装置或可用于远程评估和监测心力衰竭患者心功能，及时发现患者病情变化。

关键词: 心力衰竭, 心音心电图, 机电激活时间, 可穿戴设备