Bayesian denoising framework of phonocardiogram based on a new dynamical model

HBNET: A blended ensemble model for the detection of cardiovascular anomalies using phonocardiogram

BACKGROUND

Cardiac diseases are highly detrimental illnesses, responsible for approximately 32% of global mortality [1]. Early diagnosis and prompt treatment can reduce deaths caused by cardiac diseases. In paediatric patients, it is challenging for paediatricians to identify functional murmurs and pathological murmurs from heart sounds.

OBJECTIVE

The study intends to develop a novel blended ensemble model using hybrid deep learning models and softmax regression to classify adult, and paediatric heart sounds into five distinct classes, distinguishing itself as a groundbreaking work in this domain. Furthermore, the research aims to create a comprehensive 5-class paediatric phonocardiogram (PCG) dataset. The dataset includes two critical pathological classes, namely atrial septal defects and ventricular septal defects, along with functional murmurs, pathological and normal heart sounds.

METHODS

The work proposes a blended ensemble model (HbNet-Heartbeat Network) comprising two hybrid models, CNN-BiLSTM and CNN-LSTM, as base models and Softmax regression as meta-learner. HbNet leverages the strengths of base models and improves the overall PCG classification accuracy. Mel Frequency Cepstral Coefficients (MFCC) capture the crucial audio signal characteristics relevant to the classification. The amalgamation of these two deep learning structures enhances the precision and reliability of PCG classification, leading to improved diagnostic results.

RESULTS

The HbNet model exhibited excellent results with an average accuracy of 99.72% and sensitivity of 99.3% on an adult dataset, surpassing all the existing state-of-the-art works. The researchers have validated the reliability of the HbNet model by testing it on a real-time paediatric dataset. The paediatric model's accuracy is 86.5%. HbNet detected functional murmur with 100% precision.

CONCLUSION

The results indicate that the HbNet model exhibits a high level of efficacy in the early detection of cardiac disorders. Results also imply that HbNet has the potential to serve as a valuable tool for the development of decision-support systems that aid medical practitioners in confirming their diagnoses. This method makes it easier for medical professionals to diagnose and initiate prompt treatment while performing preliminary auscultation and reduces unnecessary echocardiograms.

Automated Assessment of the Quality of Phonocardographic Recordings through Signal-to-Noise Ratio for Home Monitoring Applications

The signal quality limits the applicability of phonocardiography at the patients’ domicile. This work proposes the signal-to-noise ratio of the recorded signal as its main quality metrics. Moreover, we define the minimum acceptable values of the signal-to-noise ratio that warrantee an accuracy of the derived parameters acceptable in clinics. We considered 25 original heart sounds recordings, which we corrupted by adding noise to decrease their signal-to-noise ratio. We found that a signal-to-noise ratio equal to or higher than 14 dB warrants an uncertainty of the estimate of the valve closure latencies below 1 ms. This accuracy is higher than that required by most clinical applications. We validated the proposed method against a public database, obtaining results comparable to those obtained on our sample population. In conclusion, we defined (a) the signal-to-noise ratio of the phonocardiographic signal as the preferred metric to evaluate its quality and (b) the minimum values of the signal-to-noise ratio required to obtain an uncertainty of the latency of heart sound components compatible with clinical applications. We believe these results are crucial for the development of home monitoring systems aimed at preventing acute episodes of heart failure and that can be safely operated by naïve users.

A Wavelet Transform-Based Neural Network Denoising Algorithm for Mobile Phonocardiography

Cardiovascular pathologies cause 23.5% of human deaths, worldwide. An auto-diagnostic system monitoring heart activity, which can identify the early symptoms of cardiac illnesses, might reduce the death rate caused by these problems. Phonocardiography (PCG) is one of the possible techniques able to detect heart problems. Nevertheless, acoustic signal enhancement is required since it is exposed to various disturbances coming from different sources. The most common denoising enhancement is based on the Wavelet Transform (WT). However, the WT is highly susceptible to variations in the noise frequency distribution. This paper proposes a new adaptive denoising algorithm, which combines WT and Time Delay Neural Networks (TDNN). The acquired signal is decomposed by means of the WT using the coif five-wavelet basis at the tenth decomposition level and then provided as input to the TDNN. Besides the advantage of adaptive thresholding, the reason for using TDNNs is their capacity of estimating the Inverse Wavelet Transform (IWT). The best parameters of the TDNN were found for a NN consisting of 25 neurons in the first and 15 in the second layer and the delay block of 12 samples. The method was evaluated on several pathological heart sounds and on signals recorded in a noisy environment. The performance of the developed system with respect to other wavelet-based denoising approaches was validated by the online questionnaire.

A Phonocardiographic-Based Fiber-Optic Sensor and Adaptive Filtering System for Noninvasive Continuous Fetal Heart Rate Monitoring

This paper focuses on the design, realization, and verification of a novel phonocardiographic- based fiber-optic sensor and adaptive signal processing system for noninvasive continuous fetal heart rate (fHR) monitoring. Our proposed system utilizes two Mach-Zehnder interferometeric sensors. Based on the analysis of real measurement data, we developed a simplified dynamic model for the generation and distribution of heart sounds throughout the human body. Building on this signal model, we then designed, implemented, and verified our adaptive signal processing system by implementing two stochastic gradient-based algorithms: the Least Mean Square Algorithm (LMS), and the Normalized Least Mean Square (NLMS) Algorithm. With this system we were able to extract the fHR information from high quality fetal phonocardiograms (fPCGs), filtered from abdominal maternal phonocardiograms (mPCGs) by performing fPCG signal peak detection. Common signal processing methods such as linear filtering, signal subtraction, and others could not be used for this purpose as fPCG and mPCG signals share overlapping frequency spectra. The performance of the adaptive system was evaluated by using both qualitative (gynecological studies) and quantitative measures such as: Signal-to-Noise Ratio—SNR, Root Mean Square Error—RMSE, Sensitivity—S+, and Positive Predictive Value—PPV.

The electronic stethoscope

Most heart diseases are associated with and reflected by the sounds that the heart produces. Heart auscultation, defined as listening to the heart sound, has been a very important method for the early diagnosis of cardiac dysfunction. Traditional auscultation requires substantial clinical experience and good listening skills. The emergence of the electronic stethoscope has paved the way for a new field of computer-aided auscultation. This article provides an in-depth study of (1) the electronic stethoscope technology, and (2) the methodology for diagnosis of cardiac disorders based on computer-aided auscultation. The paper is based on a comprehensive review of (1) literature articles, (2) market (state-of-the-art) products, and (3) smartphone stethoscope apps. It covers in depth every key component of the computer-aided system with electronic stethoscope, from sensor design, front-end circuitry, denoising algorithm, heart sound segmentation, to the final machine learning techniques. Our intent is to provide an informative and illustrative presentation of the electronic stethoscope, which is valuable and beneficial to academics, researchers and engineers in the technical field, as well as to medical professionals to facilitate its use clinically. The paper provides the technological and medical basis for the development and commercialization of a real-time integrated heart sound detection, acquisition and quantification system.

Heart monitoring systems--a review

To diagnose health status of the heart, heart monitoring systems use heart signals produced during each cardiac cycle. Many types of signals are acquired to analyze heart functionality and hence several heart monitoring systems such as phonocardiography, electrocardiography, photoplethysmography and seismocardiography are used in practice. Recently, focus on the at-home monitoring of the heart is increasing for long term monitoring, which minimizes risks associated with the patients diagnosed with cardiovascular diseases. It leads to increasing research interest in portable systems having features such as signal transmission capability, unobtrusiveness, and low power consumption. In this paper we intend to provide a detailed review of recent advancements of such heart monitoring systems. We introduce the heart monitoring system in five modules: (1) body sensors, (2) signal conditioning, (3) analog to digital converter (ADC) and compression, (4) wireless transmission, and (5) analysis and classification. In each module, we provide a brief introduction about the function of the module, recent developments, and their limitation and challenges.

Wavelet-based denoising method for real phonocardiography signal recorded by mobile devices in noisy environment

The main obstacle in development of intelligent autodiagnosis medical systems based on the analysis of phonocardiography (PCG) signals is noise. The noise can be caused by digestive and respiration sounds, movements or even signals from the surrounding environment and it is characterized by wide frequency and intensity spectrum. This spectrum overlaps the heart tones spectrum, which makes the problem of PCG signal filtrating complex. The most common method for filtering such signals are wavelet denoising algorithms. In previous studies, in order to determine the optimum wavelet denoising parameters the disturbances were simulated by Gaussian white noise. However, this paper shows that this noise has a variable character. Therefore, the purpose of this paper is adaptation of a wavelet denoising algorithm for the filtration of real PCG signal disturbances from signals recorded by a mobile devices in a noisy environment. The best results were obtained for Coif 5 wavelet at the 10th decomposition level with the use of a minimaxi threshold selection algorithm and mln rescaling function. The performance of the algorithm was tested on four pathological heart sounds: early systolic murmur, ejection click, late systolic murmur and pansystolic murmur.