Open AccessVocal Biomarker Is Associated With Hospitalization and Mortality Among Heart Failure Patients
Author(s) -
Maor Elad,
Perry Daniella,
Mevorach Dana,
Taiblum Nimrod,
Luz Yotam,
Mazin Israel,
Lerman Amir,
Koren Gideon,
Shalev Varda
Publication year - 2020
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.119.013359
Subject(s) - medicine , interquartile range , quartile , biomarker , heart failure , cohort , population , cohort study , proportional hazards model , survival analysis , cardiology , confidence interval , biochemistry , chemistry , environmental health
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.