1
|
Wang M, Hu Y, Guo B, Tang H. Simulation of Acute Pulmonary Hypertension in Beagle Dogs. Int Heart J 2022; 63:612-622. [PMID: 35650161 DOI: 10.1536/ihj.21-676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Acoustic cardiography (AC) combined with heart sound (HS) recording and electrocardiogram (ECG) provides a noninvasive and inexpensive way to understand the electrical mechanical activity of the heart. Pulmonary artery stenosis can cause hemodynamic abnormalities that might lead to pulmonary hypertension (PH). In this paper, we examined the relationships between the acoustic characteristics of the AC and hemodynamic changes in a beagle dog model of PH.Four healthy beagle dogs were injected with the prostaglandin endoperoxide receptor agonist U-44069 to induce acute PH states. AC was employed to analyze the process of pre-PH, intra-PH, and post-PH. Right ventricular blood pressure (RVBP) was measured via right cardiac catheterization, an invasive method performed in parallel for comparative hemodynamic evaluation. As RVBP increased or decreased, the HS features changed accordingly during acute PH occurrence and development. Right ventricular systolic blood pressure (RVSBP) significantly correlated with the minimum of the first HS (S1) amplitude (correlation coefficient (CC) = -0.82), energy of the S1 (CC = 0.86), energy of the second HS (S2) (CC = 0.67), entropy of the S1 (CC = -0.94), and ratio of electromechanical systolic time (EMST) to the cardiac cycle time (CC = 0.81). The two techniques (AC [HSs and ECG] versus right cardiac catheterization [RVBP]) were significantly correlated. Especially, the diastolic filling time (DFT) had a significant relationship with the right ventricular diastolic time (RVDT) (CC = 0.97), perfusion time (PT) (CC = 0.96), and cardiac cycle time (RR) (CC = 0.96). The CCs between the RVDT and the max dp/dt to min dp/dt, the EMST and the Q to min dp/dt, and the electromechanical activation time and the Q to max dp/dt were 0.95, 0.99, and 0.86, respectively. Furthermore, the logistic regression model with different combinations was used to identify the effective features for monitoring hemodynamic and pathophysiologic conditions.AC provided significant insight into mechanical dysfunction in a rapid and noninvasive way that could be used for early screening of PH.
Collapse
Affiliation(s)
- Miao Wang
- School of Biomedical Engineering, Dalian University of Technology
| | - YaTing Hu
- School of Biomedical Engineering, Dalian University of Technology
| | - BinBin Guo
- School of Biomedical Engineering, Dalian University of Technology
| | - Hong Tang
- School of Biomedical Engineering, Dalian University of Technology
| |
Collapse
|
2
|
Wang M, Wang J, Hu Y, Guo B, Tang H. Detection of pulmonary hypertension with six training strategies based on deep learning technology. Comput Intell 2022. [DOI: 10.1111/coin.12527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Miao Wang
- School of Biomedical Engineering Dalian University of Technology Dalian China
| | - JiWen Wang
- Cardiovascular Department The Second Hospital of DaLian Medical University Dalian China
| | - YaTing Hu
- School of Biomedical Engineering Dalian University of Technology Dalian China
| | - BinBin Guo
- School of Biomedical Engineering Dalian University of Technology Dalian China
| | - Hong Tang
- School of Biomedical Engineering Dalian University of Technology Dalian China
| |
Collapse
|
3
|
Continuous and Noninvasive Estimation of Right Ventricle Systolic Blood Pressure Using Heart Sound Signal by Deep Bidirectional LSTM Network. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10165466] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objective: Timely monitoring right ventricular systolic blood pressure (RVSBP) is helpful in the early detection of pulmonary hypertension (PH). However, it is not easy to monitor RVSBP directly. The objective of this paper is to develop a deep learning technique for RVSBP noninvasive estimation using heart sound (HS) signals supported by (electrocardiography) ECG signals without complex features extraction. Methods: Five beagle dog subjects were used. The medicine U-44069 was injected into the subjects to induce a wide range of RVSBP variation. The blood pressure in right ventricle, ECG of lead I and HS signals were recorded simultaneously. Thirty-two records were collected. The relations between RVSBP and cyclic HS signals were modeled by the Bidirectional Long Short-Term Memory (Bi-LSTM) network. Results: The mean absolute error (MAE) ± standard deviation (SD) inside record was 1.85 ± 1.82 mmHg. It was 4.37 ± 2.49 mmHg across record but within subject. The corrective factors were added after training the Bi-LSTM network across subjects. Finally, the MAE ± SD from 12.46 ± 6.56 mmHg dropped to 6.37 ± 4.90 mmHg across subjects. Significance: Our work was the first to apply the Bi-LSTM network to build relations between the HS signal and RVSBP. This work suggested a noninvasive and continuous RVSBP estimation using the HS signal supported by the ECG signal by deep learning architecture without the need of healthcare professionals.
Collapse
|
4
|
Ramanathan A, Zhou L, Marzbanrad F, Roseby R, Tan K, Kevat A, Malhotra A. Digital stethoscopes in paediatric medicine. Acta Paediatr 2019; 108:814-822. [PMID: 30536440 DOI: 10.1111/apa.14686] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/29/2018] [Accepted: 12/04/2018] [Indexed: 12/30/2022]
Abstract
AIM To explore, synthesise and discuss currently available digital stethoscopes (DS) and the evidence for their use in paediatric medicine. METHODS Systematic review and narrative synthesis of digital stethoscope use in paediatrics following searches of OVID Medline, Embase, Scopus, PubMed and Google Scholar databases. RESULTS Six digital stethoscope makes were identified to have been used in paediatric focused studies so far. A total of 25 studies of DS use in paediatrics were included. We discuss the use of digital stethoscope technology in current paediatric medicine, comment on the technical properties of the available devices, the effectiveness and limitations of this technology, and potential uses in the fields of paediatrics and neonatology, from telemedicine to computer-aided diagnostics. CONCLUSION Further validation and testing of available DS devices is required. Comparison studies between different types of DS would be useful in identifying strengths and flaws of each DS as well as identifying clinical situations for which each may be most appropriately suited.
Collapse
Affiliation(s)
| | - Lindsay Zhou
- Monash Newborn Monash Children's Hospital Melbourne VIC Australia
| | - Faezeh Marzbanrad
- Department of Electrical and Computer Systems Engineering Monash University Melbourne VIC Australia
| | - Robert Roseby
- Department of Paediatrics Monash University Melbourne VIC Australia
- Department of Paediatric Respiratory Medicine Monash Children's Hospital Melbourne VIC Australia
| | - Kenneth Tan
- Department of Paediatrics Monash University Melbourne VIC Australia
- Monash Newborn Monash Children's Hospital Melbourne VIC Australia
- The Ritchie Centre Hudson Institute of Medical Research Melbourne VIC Australia
| | - Ajay Kevat
- Department of Paediatrics Monash University Melbourne VIC Australia
| | - Atul Malhotra
- Department of Paediatrics Monash University Melbourne VIC Australia
- Monash Newborn Monash Children's Hospital Melbourne VIC Australia
- The Ritchie Centre Hudson Institute of Medical Research Melbourne VIC Australia
| |
Collapse
|
5
|
Tang H, Jiang Y, Li T, Wang X. Identification of Pulmonary Hypertension Using Entropy Measure Analysis of Heart Sound Signal. ENTROPY 2018; 20:e20050389. [PMID: 33265479 PMCID: PMC7512907 DOI: 10.3390/e20050389] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/16/2018] [Accepted: 05/19/2018] [Indexed: 11/16/2022]
Abstract
This study introduced entropy measures to analyze the heart sound signals of people with and without pulmonary hypertension (PH). The lead II Electrocardiography (ECG) signal and heart sound signal were simultaneously collected from 104 subjects aged between 22 and 89. Fifty of them were PH patients and 54 were healthy. Eleven heart sound features were extracted and three entropy measures, namely sample entropy (SampEn), fuzzy entropy (FuzzyEn) and fuzzy measure entropy (FuzzyMEn) of the feature sequences were calculated. The Mann–Whitney U test was used to study the feature significance between the patient and health group. To reduce the age confounding factor, nine entropy measures were selected based on correlation analysis. Further, the probability density function (pdf) of a single selected entropy measure of both groups was constructed by kernel density estimation, as well as the joint pdf of any two and multiple selected entropy measures. Therefore, a patient or a healthy subject can be classified using his/her entropy measure probability based on Bayes’ decision rule. The results showed that the best identification performance by a single selected measure had sensitivity of 0.720 and specificity of 0.648. The identification performance was improved to 0.680, 0.796 by the joint pdf of two measures and 0.740, 0.870 by the joint pdf of multiple measures. This study showed that entropy measures could be a powerful tool for early screening of PH patients.
Collapse
Affiliation(s)
- Hong Tang
- Department of Biomedical Engineering, Dalian University of Technology, Dalian 116024, China
- Correspondence: ; Tel.: +86-411-8470-6009 (ext. 3013)
| | - Yuanlin Jiang
- Department of Biomedical Engineering, Dalian University of Technology, Dalian 116024, China
| | - Ting Li
- College of Information and Communication Engineering, Dalian Minzu University, Dalian 116024, China
| | - Xinpei Wang
- School of Control Science and Engineering, Shandong University, Jinan 250100, China
| |
Collapse
|
6
|
Elgendi M, Bobhate P, Jain S, Guo L, Rutledge J, Coe Y, Zemp R, Schuurmans D, Adatia I. The Voice of the Heart: Vowel-Like Sound in Pulmonary Artery Hypertension. Diseases 2018; 6:E26. [PMID: 29652794 PMCID: PMC6023489 DOI: 10.3390/diseases6020026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 04/05/2018] [Accepted: 04/10/2018] [Indexed: 11/16/2022] Open
Abstract
Increased blood pressure in the pulmonary artery is referred to as pulmonary hypertension and often is linked to loud pulmonic valve closures. For the purpose of this paper, it was hypothesized that pulmonary circulation vibrations will create sounds similar to sounds created by vocal cords during speech and that subjects with pulmonary artery hypertension (PAH) could have unique sound signatures across four auscultatory sites. Using a digital stethoscope, heart sounds were recorded at the cardiac apex, 2nd left intercostal space (2LICS), 2nd right intercostal space (2RICS), and 4th left intercostal space (4LICS) undergoing simultaneous cardiac catheterization. From the collected heart sounds, relative power of the frequency band, energy of the sinusoid formants, and entropy were extracted. PAH subjects were differentiated by applying the linear discriminant analysis with leave-one-out cross-validation. The entropy of the first sinusoid formant decreased significantly in subjects with a mean pulmonary artery pressure (mPAp) ≥ 25 mmHg versus subjects with a mPAp < 25 mmHg with a sensitivity of 84% and specificity of 88.57%, within a 10-s optimized window length for heart sounds recorded at the 2LICS. First sinusoid formant entropy reduction of heart sounds in PAH subjects suggests the existence of a vowel-like pattern. Pattern analysis revealed a unique sound signature, which could be used in non-invasive screening tools.
Collapse
Affiliation(s)
- Mohamed Elgendi
- Department of Obstetrics & Gynecology, University of British Columbia and BC Children's & Women's Hospital, Vancouver, BC V6H 3N1, Canada.
- School of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Prashant Bobhate
- Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB T6G 2B7, Canada.
| | - Shreepal Jain
- Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB T6G 2B7, Canada.
| | - Long Guo
- Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB T6G 2B7, Canada.
| | - Jennifer Rutledge
- Division of Cardiology at Alberta Children's Hospital, Calgary, AB T3B 6A8, Canada.
| | - Yashu Coe
- Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB T6G 2B7, Canada.
- Mazankowski Alberta Heart Institute, Edmonton, AB T6G 2B7, Canada.
| | - Roger Zemp
- School of Biomedical Engineering, University of Alberta, Edmonton, AB T6G 2V2, Canada.
| | - Dale Schuurmans
- Department of Computing Science, University of Alberta, Edmonton, AB T6G 2E8, Canada.
| | - Ian Adatia
- Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB T6G 2B7, Canada.
- Mazankowski Alberta Heart Institute, Edmonton, AB T6G 2B7, Canada.
| |
Collapse
|
7
|
Elgendi M, Howard N, Lovell N, Cichocki A, Brearley M, Abbott D, Adatia I. A Six-Step Framework on Biomedical Signal Analysis for Tackling Noncommunicable Diseases: Current and Future Perspectives. JMIR BIOMEDICAL ENGINEERING 2016. [DOI: 10.2196/biomedeng.6401] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
8
|
Kaddoura T, Vadlamudi K, Kumar S, Bobhate P, Guo L, Jain S, Elgendi M, Coe JY, Kim D, Taylor D, Tymchak W, Schuurmans D, Zemp RJ, Adatia I. Acoustic diagnosis of pulmonary hypertension: automated speech- recognition-inspired classification algorithm outperforms physicians. Sci Rep 2016; 6:33182. [PMID: 27609672 PMCID: PMC5016849 DOI: 10.1038/srep33182] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/19/2016] [Indexed: 12/14/2022] Open
Abstract
We hypothesized that an automated speech- recognition-inspired classification algorithm could differentiate between the heart sounds in subjects with and without pulmonary hypertension (PH) and outperform physicians. Heart sounds, electrocardiograms, and mean pulmonary artery pressures (mPAp) were recorded simultaneously. Heart sound recordings were digitized to train and test speech-recognition-inspired classification algorithms. We used mel-frequency cepstral coefficients to extract features from the heart sounds. Gaussian-mixture models classified the features as PH (mPAp ≥ 25 mmHg) or normal (mPAp < 25 mmHg). Physicians blinded to patient data listened to the same heart sound recordings and attempted a diagnosis. We studied 164 subjects: 86 with mPAp ≥ 25 mmHg (mPAp 41 ± 12 mmHg) and 78 with mPAp < 25 mmHg (mPAp 17 ± 5 mmHg) (p < 0.005). The correct diagnostic rate of the automated speech-recognition-inspired algorithm was 74% compared to 56% by physicians (p = 0.005). The false positive rate for the algorithm was 34% versus 50% (p = 0.04) for clinicians. The false negative rate for the algorithm was 23% and 68% (p = 0.0002) for physicians. We developed an automated speech-recognition-inspired classification algorithm for the acoustic diagnosis of PH that outperforms physicians that could be used to screen for PH and encourage earlier specialist referral.
Collapse
Affiliation(s)
- Tarek Kaddoura
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, Canada
| | - Karunakar Vadlamudi
- Pediatric Pulmonary Hypertension Service, Pediatric Cardiac Critical Care Unit, Stollery Children's Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
| | - Shine Kumar
- Pediatric Pulmonary Hypertension Service, Pediatric Cardiac Critical Care Unit, Stollery Children's Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
| | - Prashant Bobhate
- Pediatric Pulmonary Hypertension Service, Pediatric Cardiac Critical Care Unit, Stollery Children's Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
| | - Long Guo
- Pediatric Pulmonary Hypertension Service, Pediatric Cardiac Critical Care Unit, Stollery Children's Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
| | - Shreepal Jain
- Pediatric Pulmonary Hypertension Service, Pediatric Cardiac Critical Care Unit, Stollery Children's Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
| | - Mohamed Elgendi
- Department Computing Science, University of Alberta, Edmonton, Canada
| | - James Y Coe
- Pediatric Pulmonary Hypertension Service, Pediatric Cardiac Critical Care Unit, Stollery Children's Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
| | - Daniel Kim
- Department of Medicine, Division of Cardiology, Cardiac Catheterization Laboratories, University of Alberta Hospital, Mazankowski Alberta Heart Institute, Edmonton, Canada
| | - Dylan Taylor
- Department of Medicine, Division of Cardiology, Cardiac Catheterization Laboratories, University of Alberta Hospital, Mazankowski Alberta Heart Institute, Edmonton, Canada
| | - Wayne Tymchak
- Department of Medicine, Division of Cardiology, Cardiac Catheterization Laboratories, University of Alberta Hospital, Mazankowski Alberta Heart Institute, Edmonton, Canada
| | - Dale Schuurmans
- Department Computing Science, University of Alberta, Edmonton, Canada
| | - Roger J Zemp
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, Canada
| | - Ian Adatia
- Pediatric Pulmonary Hypertension Service, Pediatric Cardiac Critical Care Unit, Stollery Children's Hospital, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
| |
Collapse
|