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

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

Characterization, Classification, and Genesis of Seismocardiographic Signals

Seismocardiographic (SCG) signals are the acoustic and vibration induced by cardiac activity measured non-invasively at the chest surface. These signals may offer a method for diagnosing and monitoring heart function. Successful classification of SCG signals in health and disease depends on accurate signal characterization and feature extraction. In this study, SCG signal features were extracted in the time, frequency, and time-frequency domains. Different methods for estimating time-frequency features of SCG were investigated. Results suggested that the polynomial chirplet transform outperformed wavelet and short time Fourier transforms. Many factors may contribute to increasing intrasubject SCG variability including subject posture and respiratory phase. In this study, the effect of respiration on SCG signal variability was investigated. Results suggested that SCG waveforms can vary with lung volume, respiratory flow direction, or a combination of these criteria. SCG events were classified into groups belonging to these different respiration phases using classifiers, including artificial neural networks, support vector machines, and random forest. Categorizing SCG events into different groups containing similar events allows more accurate estimation of SCG features. SCG feature points were also identified from simultaneous measurements of SCG and other well-known physiologic signals including electrocardiography, phonocardiography, and echocardiography. Future work may use this information to get more insights into the genesis of SCG

Wrist-based Phonocardiogram Diagnosis Leveraging Machine Learning

With the tremendous growth of technology and the fast pace of life, the need for instant information has become an everyday necessity, more so in emergency cases when every minute counts towards saving lives. mHealth has been the adopted approach for quick diagnosis using mobile devices. However, it has been challenging due to the required high quality of data, high computation load, and high-power consumption. The aim of this research is to diagnose the heart condition based on phonocardiogram (PCG) analysis using Machine Learning techniques assuming limited processing power, in order to be encapsulated later in a mobile device. The diagnosis of PCG is performed using two techniques; 1. parametric estimation with multivariate classification, particularly discriminant function. Which will be explored at length using different number of descriptive features. The feature extraction will be performed using Wavelet Transform (Filter Bank). 2. Artificial Neural Networks, and specifically Pattern Recognition. This will also use decomposed version of PCG using Wavelet Transform (Filter Bank). The results showed 97.33% successful diagnosis using the first technique using PCG with a 19 dB Signal-to-Noise-Ratio. When the signal was decomposed into four sub-bands using a Filter Bank of the second order. Each sub-band was described using two features; the signal’s mean and covariance. Additionally, different Filter Bank orders and number of features are explored and compared. Using the second technique the diagnosis resulted in a 100% successful classification with 83.3% trust level. The results are assessed, and new improvements are recommended and discussed as part of future work.Teknologian valtavan kehittymisen ja nopean elämänrytmin myötä välittömästi saatu tieto on noussut jokapäiväiseksi välttämättömyydeksi, erityisesti hätätapauksissa, joissa jokainen säästetty minuutti on tärkeää ihmishenkien pelastamiseksi. Mobiiliterveys, eli mHealth, on yleisesti valjastettu käyttöön nopeaksi diagnoosimenetelmäksi mobiililaitteiden avulla. Käyttö on kuitenkin ollut haastavaa korkean datan laatuvaatimuksen ja suurten tiedonkäsittelyvaatimuksien, nopean laskentatehon ja sekä suuren virrankulutuksen vuoksi. Tämän tutkimuksen tavoitteena oli diagnosoida sydänsairauksia fonokardiogrammianalyysin (PCG) perusteella käyttämällä koneoppimistekniikoita niin, että käytettävä laskentateho rajoitetaan vastaamaan mobiililaitteiden kapasiteettia. PCG-diagnoosi tehtiin käyttäen kahta tekniikkaa 1. Parametrinen estimointi käyttäen moniulotteista luokitusta, erityisesti signaalien erotteluanalyysin avulla. Tätä asiaa tutkittiin syvällisesti käyttäen erilaisia tilastotieteellisesti kuvailevia piirteitä. Piirteiden irrotus suoritettiin käyttäen Wavelet-muunnosta ja suodatinpankkia. 2. Keinotekoisia neuroverkkoja ja erityisesti hahmontunnistusta. Tässä menetelmässä käytetään myös PCG-signaalin hajoitusta ja Wavelet-muunnos -suodatinpankkia. Tulokset osoittivat, että PCG 19dB:n signaali-kohina-suhteella voi johtaa 97,33% onnistuneeseen diagnoosiin käytettäessä ensimmäistä tekniikkaa. Signaalin hajottaminen neljään alikaistaan suoritettiin käyttämällä toisen asteen suodatinpankkia. Jokainen alikaista kuvattiin käyttäen kahta piirrettä: signaalin keskiarvoa ja kovarianssia, näin saatiin yhteensä kahdeksan ominaisuutta kuvaamaan noin yhden minuutin näytettä PCG-signaalista. Lisäksi tutkittiin ja verrattiin eriasteisia suodattimia ja piirteitä. Toista tekniikkaa käyttäen diagnoosi johti 100% onnistuneeseen luokitteluun 83,3% luotettavuustasolla. Tuloksia käsitellään ja pohditaan, sekä tehdään niistä johtopäätöksiä. Lopuksi ehdotetaan ja suositellaan käytettyihin menetelmiin uusia parannuksia jatkotutkimuskohteiksi.fi=vertaisarvioitu|en=peerReviewed

A comparative study of single-channel signal processing methods in fetal phonocardiography

Fetal phonocardiography is a non-invasive, completely passive and low-cost method based on sensing acoustic signals from the maternal abdomen. However, different types of interference are sensed along with the desired fetal phonocardiography. This study focuses on the comparison of fetal phonocardiography filtering using eight algorithms: Savitzky-Golay filter, finite impulse response filter, adaptive wavelet transform, maximal overlap discrete wavelet transform, variational mode decomposition, empirical mode decomposition, ensemble empirical mode decomposition, and complete ensemble empirical mode decomposition with adaptive noise. The effectiveness of those methods was tested on four types of interference (maternal sounds, movement artifacts, Gaussian noise, and ambient noise) and eleven combinations of these disturbances. The dataset was created using two synthetic records r01 and r02, where the record r02 was loaded with higher levels of interference than the record r01. The evaluation was performed using the objective parameters such as accuracy of the detection of S1 and S2 sounds, signal-to-noise ratio improvement, and mean error of heart interval measurement. According to all parameters, the best results were achieved using the complete ensemble empirical mode decomposition with adaptive noise method with average values of accuracy = 91.53% in the detection of S1 and accuracy = 68.89% in the detection of S2. The average value of signal-to-noise ratio improvement achieved by complete ensemble empirical mode decomposition with adaptive noise method was 9.75 dB and the average value of the mean error of heart interval measurement was 3.27 ms.Web of Science178art. no. e026988

Analyse et reconnaissance de signaux vibratoires : contribution au traitement et à l'analyse de signaux cardiaques pour la télémédecine

The heart is a muscle. Its mechanical operation is like a pump charged for distributing and retrieving the blood in the lungs and cardiovascular system. Its electrical operation is regulated by the sinus node, a pacemaker or electric regulator responsible for triggering the natural heart beats that punctuate the functioning of the body.Doctors monitor the electromechanical functioning of the heart by recording an electrical signal called an electrocardiogram (ECG) or an audible signal : the phonocardiogram (PCG). The analysis and processing of these two signals are essential for diagnosis, to help detect anomalies and cardiac pathologies.The objective of this thesis is to develop signal processing tools on ECG and PCG to assist cardiologist in his analysis of these signals. The basic idea is to develop algorithms of low complexity and having inexpensive computing time. The primary interest is to ensure their easy implementation in a mobile heart monitoring system for use by the doctor or the patient. The second advantage lies in the possibility of automatic real-time analysis of signals with the mobile device, allowing control of the transmission of these signals to a removal of doubt.Numerous studies have led to significant advances in the analysis of ECG signals and the automatic recognition of cardiac conditions. Databases of real or synthetic signals annotated also assess the performance of new methods. PCG signals are much less studied, difficult to analyze and to interpret. The main methods (Fourier, wavelet and Wigner Ville) were tested : they do not allow automatic recognition of signatures, and an accurate understanding of their contents.Wavelet Transform (WT) on cardiac signals showed its effectiveness to filter and locate useful information, but it involves an external processing function (mother wavelet) whose the choice depends on the prior knowledge on the signal to be processed. This is not always suitable for cardiac signals. Moreover, the wavelet transform generally induces inaccuracies in the location due to the external function and optionally due to the sub- sampling of the signatures.The non-stationary nature of the ECG and PCG and their sensitivity to noise makes it difficult to separate an informative transition of a transition due to measurement noise. The choice of treatment tool should allow denoising and analysis of these signals without alteration or the processing tool delocalization of the singularities.In response to our objectives and considering these problems, we propose to rely primarily on empirical mode decomposition (EMD) and Hilbert Huang Transform (HHT) to develop solutions. The EMD is a non linear approach decomposing the signal in intrinsic signal (IMF), oscillations of the type FM-AM, giving a time/scale signal representation. Associated with the Hilbert transform (TH), the THH determines the instantaneous amplitude (IA) and instantaneous frequency (IF) of each mode, leading to a time/frequency representation of the ECG and PCG.Without involving an external function, EMD approach can restore (noise reduction), analyze and reconstruct the signal without relocation of its singularities. This approach allows to locate R peaks of the ECG, heart rate and study the cardiac frequency variability (CFV), locate and analyze the sound components B1 and B2 of the PCG.Among the trials and developments that we made, we present in particular a new method (EDA : empirical denoising approach) inspired by the EMD approach for denoising cardiac signals. We also set out the implementation of two approaches for locating ECG signature (QRS complex, T and P waves). The first is based on the detection of local maxima : in using Modulus Maxima and Lipschitz exponent followed by a classifier. The second uses NFLS, wich an nonlinear approach for the detection and location of unique transitions in the discrete domain.Le coeur est un muscle. Son fonctionnement mécanique est celui d'une pompe chargée de distribuer et de récupérer le sang dans les poumons et dans le système cardiovasculaire. Son fonctionnement électrique est régulé par le son noeud sinusal, un stimulateur ou régulateur électrique chargé de déclencher les battements naturels du coeur qui rythment le fonctionnement du corps. Les médecins surveillent ce fonctionnement électromécanique du coeur en enregistrant un signal électrique appelé électrocardiogramme (ECG) ou un signal sonore : le phono-cardiogramme (PCG). L'analyse et le traitement de ces deux signaux sont fondamentaux pour établir un diagnostic et aider à déceler des anomalies et des pathologies cardiaques. L’objectif de cette thèse est de développer des techniques de traitement des signaux ECG et notamment PCG afin d’aider le médecin dans son analyse de ces signaux. L’idée de fond est de mettre en point des algorithmes relativement simples et peu coûteux en temps de calcul. Le premier intérêt serait de garantir leur implantation aisée dans un système mobile de surveillance cardiaque à l’usage du médecin, voire du patient. Le deuxième intérêt réside dans la possibilité d’une analyse automatique en temps réel des signaux avec le dispositif mobile, autorisant le choix de la transmission de ces signaux pour une levée de doute. De nombreux travaux ont mené à des avancées significatives dans l’analyse des signaux ECG et la reconnaissance automatiques des pathologies cardiaques. Des bases de données de signaux réels ou synthétiques annotées permettent également d’évaluer les performances de toute nouvelle méthode. Quant aux signaux PCG, ils sont nettement moins étudiés, difficiles à analyser et à interpréter. Même si les grandes familles de méthodes (Fourier, Wigner Ville et ondelettes) ont été testées, elles n’autorisent pas une reconnaissance automatique des signatures, d’en avoir une analyse et une compréhension assez fines.La Transformée en Ondelettes (TO) sur les signaux cardiaques a montré son efficacité pour filtrer et localiser les informations utiles mais elle fait intervenir une fonction externe de traitement (ondelette mère) dont le choix dépend de la connaissance au préalable du signal à traiter. Ce n'est pas toujours adapté aux signaux cardiaques. De plus, la Transformée en ondelettes induit généralement une imprécision dans la localisation due à la fonction externe et éventuellement au sous-échantillonnage des signatures. La nature non stationnaire de l'ECG et du PCG et leur sensibilité aux bruits rendent difficile la séparation d’une transition informative d'une transition due aux bruits de mesure. Le choix de l'outil de traitement doit permettre un débruitage et une analyse de ces signaux sans délocalisation des singularités ni altération de leurs caractéristiques. En réponse à nos objectifs et considérant ces différents problèmes, nous proposons de nous appuyer principalement sur la décomposition modale empirique (EMD) ou transformée de Hilbert Huang (THH) pour développer des solutions. L’EMD est une approche non linéaire capable de décomposer le signal étudié en fonctions modales intrinsèques (IMF), oscillations du type FM-AM, donnant ainsi une représentation temps/échelle du signal. Associée à la transformée de Hilbert (TH), la THH permet de déterminer les amplitudes instantanées (AI) et les fréquences instantanées (FI) de chaque mode, menant ainsi à une représentation temps/fréquence des signaux.Sans faire intervenir une fonction externe, on peut ainsi restaurer (réduction de bruit), analyser et reconstruire le signal sans délocalisation de ses singularités. Cette approche permet de localiser les pics R de l'ECG, déterminer le rythme cardiaque et étudier la variabilité fréquentielle cardiaque (VFC), localiser et analyser les composantes des bruits B1 et B2 du PCG

Estimation of Surrogate Respiration and Detection of Sleep Apnea Events from Dynamic Data Mining of Multiple Cardiorespiratory Sensors

This research investigates an approach to derive respiration waveform from heart sound signals, and compare the waveform signal obtained thus with those obtained from alternative methods for deriving respiration waveforms from measured ECG signals. The investigations indicate that HSR can lead to a cost effective alternative to the use of respiratory vests to analyze cardiorespiratory dynamics for clinical diagnostics and wellness assessments. The derived respiratory rate was further used to classify Type III sleep apnea periods using recurrence analysis. Detection of patterns causing sleep apnea could open up opportunities to researchers to better understand and predict symptoms leading to disorders linked with sleep apnea like hypertension, sudden infant death syndrome, high blood pressure and a risk of heart attack. Surrogate respiratory signals derived from heart sounds (HSR) are found to have 32% and 36% correlation with the actual respiratory signals recorded at upright and supine positions, respectively, as compared to EMD derived respiration signals (EDR) that have (18% and 26%) correlation with the respiration waveforms measured in upright and supine positions, respectively. Wavelet-derived respiration (WDR) signals show a higher wave-to-wave correlation (55% and 55%) than HSR and EDR waveforms, but the respiratory sinus arrhythmia (RSA), zero crossing intervals, and respiratory rates of the HSR correlate better with the measured values, compared with those from EDR and WDR signals. Three models were implemented using recurrence analysis to classify sleep apnea events and were compared with a vectorized time series derived model. Advanced predictive modeling tools like decision trees, neural networks and regression models were used to classify sleep apnea events form non-apneic events. Model comparison within preliminary analysis model consisting of nasal respiration as well as its time lagged components and heart rate when compared with recurrence models shows that the preliminary analysis model(vectorized time series) has a lower misclassification rate (10%) than the recurrence models( Model 1: 20% Model 2: 14%, Model 3: 12%).Industrial Engineering & Managemen

Signal Processing Using Non-invasive Physiological Sensors

Non-invasive biomedical sensors for monitoring physiological parameters from the human body for potential future therapies and healthcare solutions. Today, a critical factor in providing a cost-effective healthcare system is improving patients' quality of life and mobility, which can be achieved by developing non-invasive sensor systems, which can then be deployed in point of care, used at home or integrated into wearable devices for long-term data collection. Another factor that plays an integral part in a cost-effective healthcare system is the signal processing of the data recorded with non-invasive biomedical sensors. In this book, we aimed to attract researchers who are interested in the application of signal processing methods to different biomedical signals, such as an electroencephalogram (EEG), electromyogram (EMG), functional near-infrared spectroscopy (fNIRS), electrocardiogram (ECG), galvanic skin response, pulse oximetry, photoplethysmogram (PPG), etc. We encouraged new signal processing methods or the use of existing signal processing methods for its novel application in physiological signals to help healthcare providers make better decisions

Development of a Novel Dataset and Tools for Non-Invasive Fetal Electrocardiography Research

This PhD thesis presents the development of a novel open multi-modal dataset for advanced studies on fetal cardiological assessment, along with a set of signal processing tools for its exploitation. The Non-Invasive Fetal Electrocardiography (ECG) Analysis (NInFEA) dataset features multi-channel electrophysiological recordings characterized by high sampling frequency and digital resolution, maternal respiration signal, synchronized fetal trans-abdominal pulsed-wave Doppler (PWD) recordings and clinical annotations provided by expert clinicians at the time of the signal collection. To the best of our knowledge, there are no similar dataset available. The signal processing tools targeted both the PWD and the non-invasive fetal ECG, exploiting the recorded dataset. About the former, the study focuses on the processing aimed at the preparation of the signal for the automatic measurement of relevant morphological features, already adopted in the clinical practice for cardiac assessment. To this aim, a relevant step is the automatic identification of the complete and measurable cardiac cycles in the PWD videos: a rigorous methodology was deployed for the analysis of the different processing steps involved in the automatic delineation of the PWD envelope, then implementing different approaches for the supervised classification of the cardiac cycles, discriminating between complete and measurable vs. malformed or incomplete ones. Finally, preliminary measurement algorithms were also developed in order to extract clinically relevant parameters from the PWD. About the fetal ECG, this thesis concentrated on the systematic analysis of the adaptive filters performance for non-invasive fetal ECG extraction processing, identified as the reference tool throughout the thesis. Then, two studies are reported: one on the wavelet-based denoising of the extracted fetal ECG and another one on the fetal ECG quality assessment from the analysis of the raw abdominal recordings. Overall, the thesis represents an important milestone in the field, by promoting the open-data approach and introducing automated analysis tools that could be easily integrated in future medical devices