NRC-Net: Automated noise robust cardio net for detecting valvular cardiac diseases using optimum transformation method with heart sound signals

Cardiovascular diseases (CVDs) can be effectively treated when detected early, reducing mortality rates significantly. Traditionally, phonocardiogram (PCG) signals have been utilized for detecting cardiovascular disease due to their cost-effectiveness and simplicity. Nevertheless, various environmental and physiological noises frequently affect the PCG signals, compromising their essential distinctive characteristics. The prevalence of this issue in overcrowded and resource-constrained hospitals can compromise the accuracy of medical diagnoses. Therefore, this study aims to discover the optimal transformation method for detecting CVDs using noisy heart sound signals and propose a noise robust network to improve the CVDs classification performance.For the identification of the optimal transformation method for noisy heart sound data mel-frequency cepstral coefficients (MFCCs), short-time Fourier transform (STFT), constant-Q nonstationary Gabor transform (CQT) and continuous wavelet transform (CWT) has been used with VGG16. Furthermore, we propose a novel convolutional recurrent neural network (CRNN) architecture called noise robust cardio net (NRC-Net), which is a lightweight model to classify mitral regurgitation, aortic stenosis, mitral stenosis, mitral valve prolapse, and normal heart sounds using PCG signals contaminated with respiratory and random noises. An attention block is included to extract important temporal and spatial features from the noisy corrupted heart sound.The results of this study indicate that,CWT is the optimal transformation method for noisy heart sound signals. When evaluated on the GitHub heart sound dataset, CWT demonstrates an accuracy of 95.69% for VGG16, which is 1.95% better than the second-best CQT transformation technique. Moreover, our proposed NRC-Net with CWT obtained an accuracy of 97.4%, which is 1.71% higher than the VGG16

Fog Computing in Medical Internet-of-Things: Architecture, Implementation, and Applications

In the era when the market segment of Internet of Things (IoT) tops the chart in various business reports, it is apparently envisioned that the field of medicine expects to gain a large benefit from the explosion of wearables and internet-connected sensors that surround us to acquire and communicate unprecedented data on symptoms, medication, food intake, and daily-life activities impacting one's health and wellness. However, IoT-driven healthcare would have to overcome many barriers, such as: 1) There is an increasing demand for data storage on cloud servers where the analysis of the medical big data becomes increasingly complex, 2) The data, when communicated, are vulnerable to security and privacy issues, 3) The communication of the continuously collected data is not only costly but also energy hungry, 4) Operating and maintaining the sensors directly from the cloud servers are non-trial tasks. This book chapter defined Fog Computing in the context of medical IoT. Conceptually, Fog Computing is a service-oriented intermediate layer in IoT, providing the interfaces between the sensors and cloud servers for facilitating connectivity, data transfer, and queryable local database. The centerpiece of Fog computing is a low-power, intelligent, wireless, embedded computing node that carries out signal conditioning and data analytics on raw data collected from wearables or other medical sensors and offers efficient means to serve telehealth interventions. We implemented and tested an fog computing system using the Intel Edison and Raspberry Pi that allows acquisition, computing, storage and communication of the various medical data such as pathological speech data of individuals with speech disorders, Phonocardiogram (PCG) signal for heart rate estimation, and Electrocardiogram (ECG)-based Q, R, S detection.Comment: 29 pages, 30 figures, 5 tables. Keywords: Big Data, Body Area Network, Body Sensor Network, Edge Computing, Fog Computing, Medical Cyberphysical Systems, Medical Internet-of-Things, Telecare, Tele-treatment, Wearable Devices, Chapter in Handbook of Large-Scale Distributed Computing in Smart Healthcare (2017), Springe

Automatic analysis and classification of cardiac acoustic signals for long term monitoring

Objective: Cardiovascular diseases are the leading cause of death worldwide resulting in over 17.9 million deaths each year. Most of these diseases are preventable and treatable, but their progression and outcomes are significantly more positive with early-stage diagnosis and proper disease management. Among the approaches available to assist with the task of early-stage diagnosis and management of cardiac conditions, automatic analysis of auscultatory recordings is one of the most promising ones, since it could be particularly suitable for ambulatory/wearable monitoring. Thus, proper investigation of abnormalities present in cardiac acoustic signals can provide vital clinical information to assist long term monitoring. Cardiac acoustic signals, however, are very susceptible to noise and artifacts, and their characteristics vary largely with the recording conditions which makes the analysis challenging. Additionally, there are challenges in the steps used for automatic analysis and classification of cardiac acoustic signals. Broadly, these steps are the segmentation, feature extraction and subsequent classification of recorded signals using selected features. This thesis presents approaches using novel features with the aim to assist the automatic early-stage detection of cardiovascular diseases with improved performance, using cardiac acoustic signals collected in real-world conditions. Methods: Cardiac auscultatory recordings were studied to identify potential features to help in the classification of recordings from subjects with and without cardiac diseases. The diseases considered in this study for the identification of the symptoms and characteristics are the valvular heart diseases due to stenosis and regurgitation, atrial fibrillation, and splitting of fundamental heart sounds leading to additional lub/dub sounds in the systole or diastole interval of a cardiac cycle. The localisation of cardiac sounds of interest was performed using an adaptive wavelet-based filtering in combination with the Shannon energy envelope and prior information of fundamental heart sounds. This is a prerequisite step for the feature extraction and subsequent classification of recordings, leading to a more precise diagnosis. Localised segments of S1 and S2 sounds, and artifacts, were used to extract a set of perceptual and statistical features using wavelet transform, homomorphic filtering, Hilbert transform and mel-scale filtering, which were then fed to train an ensemble classifier to interpret S1 and S2 sounds. Once sound peaks of interest were identified, features extracted from these peaks, together with the features used for the identification of S1 and S2 sounds, were used to develop an algorithm to classify recorded signals. Overall, 99 features were extracted and statistically analysed using neighborhood component analysis (NCA) to identify the features which showed the greatest ability in classifying recordings. Selected features were then fed to train an ensemble classifier to classify abnormal recordings, and hyperparameters were optimized to evaluate the performance of the trained classifier. Thus, a machine learning-based approach for the automatic identification and classification of S1 and S2, and normal and abnormal recordings, in real-world noisy recordings using a novel feature set is presented. The validity of the proposed algorithm was tested using acoustic signals recorded in real-world, non-controlled environments at four auscultation sites (aortic valve, tricuspid valve, mitral valve, and pulmonary valve), from the subjects with and without cardiac diseases; together with recordings from the three large public databases. The performance metrics of the methodology in relation to classification accuracy (CA), sensitivity (SE), precision (P+), and F1 score, were evaluated. Results: This thesis proposes four different algorithms to automatically classify fundamental heart sounds – S1 and S2; normal fundamental sounds and abnormal additional lub/dub sounds recordings; normal and abnormal recordings; and recordings with heart valve disorders, namely the mitral stenosis (MS), mitral regurgitation (MR), mitral valve prolapse (MVP), aortic stenosis (AS) and murmurs, using cardiac acoustic signals. The results obtained from these algorithms were as follows: • The algorithm to classify S1 and S2 sounds achieved an average SE of 91.59% and 89.78%, and F1 score of 90.65% and 89.42%, in classifying S1 and S2, respectively. 87 features were extracted and statistically studied to identify the top 14 features which showed the best capabilities in classifying S1 and S2, and artifacts. The analysis showed that the most relevant features were those extracted using Maximum Overlap Discrete Wavelet Transform (MODWT) and Hilbert transform. • The algorithm to classify normal fundamental heart sounds and abnormal additional lub/dub sounds in the systole or diastole intervals of a cardiac cycle, achieved an average SE of 89.15%, P+ of 89.71%, F1 of 89.41%, and CA of 95.11% using the test dataset from the PASCAL database. The top 10 features that achieved the highest weights in classifying these recordings were also identified. • Normal and abnormal classification of recordings using the proposed algorithm achieved a mean CA of 94.172%, and SE of 92.38%, in classifying recordings from the different databases. Among the top 10 acoustic features identified, the deterministic energy of the sound peaks of interest and the instantaneous frequency extracted using the Hilbert Huang-transform, achieved the highest weights. • The machine learning-based approach proposed to classify recordings of heart valve disorders (AS, MS, MR, and MVP) achieved an average CA of 98.26% and SE of 95.83%. 99 acoustic features were extracted and their abilities to differentiate these abnormalities were examined using weights obtained from the neighborhood component analysis (NCA). The top 10 features which showed the greatest abilities in classifying these abnormalities using recordings from the different databases were also identified. The achieved results demonstrate the ability of the algorithms to automatically identify and classify cardiac sounds. This work provides the basis for measurements of many useful clinical attributes of cardiac acoustic signals and can potentially help in monitoring the overall cardiac health for longer duration. The work presented in this thesis is the first-of-its-kind to validate the results using both, normal and pathological cardiac acoustic signals, recorded for a long continuous duration of 5 minutes at four different auscultation sites in non-controlled real-world conditions.Open Acces

Prediction of Cardiovascular Diseases by Integrating Electrocardiogram (ECG) and Phonocardiogram (PCG) Multi-Modal Features using Hidden Semi Morkov Model

Because the health care field generates a large amount of data, we must employ modern ways to handle this data in order to give effective outcomes and make successful decisions based on data. Heart diseases are the major cause of mortality worldwide, accounting for 1/3th of all fatalities. Cardiovascular disease detection can be accomplished by the detection of disturbance in cardiac signals, one of which is known as phonocardiography. The aim of this project is for using machine learning to categorize cardiac illness based on electrocardiogram (ECG) and phonocardiogram (PCG) readings. The investigation began with signal preprocessing, which included cutting and normalizing the signal, and was accompanied by a continuous wavelet transformation utilizing a mother wavelet analytic morlet. The results of the decomposition are shown using a scalogram, and the outcomes are predicted using the Hidden semi morkov model (HSMM). In the first phase, we submit the dataset file and choose an algorithm to run on the chosen dataset. The accuracy of each selected method is then predicted, along with a graph, and a modal is built for the one with the max frequency by training the dataset to it. In the following step, input for each cardiac parameter is provided, and the sick stage of the heart is predicted based on the modal created. We then take measures based on the patient's condition. When compared to current approaches, the suggested HSMM has 0.952 sensitivity, 0.92 specificity, 0.94 F-score, 0.91 ACC, and 0.96 AUC

Evaluation of Pre-Trained CNN Models for Cardiovascular Disease Classification: A Benchmark Study

In this paper, we present an up-to-date benchmarking of the most commonly used pre-trained CNN models using a merged set of three available public datasets to have a large enough sample range. From the 18th century up to the present day, cardiovascular diseases, which are considered among the most significant health risks globally, have been diagnosed by the auscultation of heart sounds using a stethoscope. This method is elusive, and a highly experienced physician is required to master it. Artificial intelligence and, subsequently, machine learning are being applied to equip modern medicine with powerful tools to improve medical diagnoses. Image and audio pre-trained convolution neural network (CNN) models have been used for classifying normal and abnormal heartbeats using phonocardiogram signals. We objectively benchmark more than two dozen image-pre-trained CNN models in addition to two of the most popular audio-based pre-trained CNN models: VGGish and YAMnet, which have been developed specifically for audio classification. The experimental results have shown that audio-based models are among the best- performing models. In particular, the VGGish model had the highest average validation accuracy and average true positive rate of 87% and 85%, respectively

A Comprehensive Survey on Heart Sound Analysis in the Deep Learning Era

Heart sound auscultation has been demonstrated to be beneficial in clinical usage for early screening of cardiovascular diseases. Due to the high requirement of well-trained professionals for auscultation, automatic auscultation benefiting from signal processing and machine learning can help auxiliary diagnosis and reduce the burdens of training professional clinicians. Nevertheless, classic machine learning is limited to performance improvement in the era of big data. Deep learning has achieved better performance than classic machine learning in many research fields, as it employs more complex model architectures with stronger capability of extracting effective representations. Deep learning has been successfully applied to heart sound analysis in the past years. As most review works about heart sound analysis were given before 2017, the present survey is the first to work on a comprehensive overview to summarise papers on heart sound analysis with deep learning in the past six years 2017--2022. We introduce both classic machine learning and deep learning for comparison, and further offer insights about the advances and future research directions in deep learning for heart sound analysis