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

Biomedical Signal and Image Processing

Written for senior-level and first year graduate students in biomedical signal and image processing, this book describes fundamental signal and image processing techniques that are used to process biomedical information. The book also discusses application of these techniques in the processing of some of the main biomedical signals and images, such as EEG, ECG, MRI, and CT. New features of this edition include the technical updating of each chapter along with the addition of many more examples, the majority of which are MATLAB based

Machine Learning for Understanding Focal Epilepsy

The study of neural dysfunctions requires strong prior knowledge on brain physiology combined with expertise on data analysis, signal processing, and machine learning. One of the unsolved issues regarding epilepsy consists in the localization of pathological brain areas causing seizures. Nowadays the analysis of neural activity conducted with this goal still relies on visual inspection by clinicians and is therefore subjected to human error, possibly leading to negative surgical outcome. In absence of any evidence from standard clinical tests, medical experts resort to invasive electrophysiological recordings, such as stereoelectroencephalography to assess the pathological areas. This data is high dimensional, it could suffer from spatial and temporal correlation, as well as be affected by high variability across the population. These aspects make the automatization attempt extremely challenging. In this context, this thesis tackles the problem of characterizing drug resistant focal epilepsy. This work proposes methods to analyze the intracranial electrophysiological recordings during the interictal state, leveraging on the presurgical assessment of the pathological areas. The first contribution of the thesis consists in the design of a support tool for the identification of epileptic zones. This method relies on the multi-decomposition of the signal and similarity metrics. We built personalized models which share common usage of features across patients. The second main contribution aims at understanding if there are particular frequency bands related to the epileptic areas and if it is worthy to focus on shorter periods of time. Here we leverage on the post-surgical outcome deriving from the Engel classification. The last contribution focuses on the characterization of short patterns of activity at specific frequencies. We argue that this effort could be helpful in the clinical routine and at the same time provides useful insight for the understanding of focal epilepsy

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

Wavelet Theory

The wavelet is a powerful mathematical tool that plays an important role in science and technology. This book looks at some of the most creative and popular applications of wavelets including biomedical signal processing, image processing, communication signal processing, Internet of Things (IoT), acoustical signal processing, financial market data analysis, energy and power management, and COVID-19 pandemic measurements and calculations. The editor’s personal interest is the application of wavelet transform to identify time domain changes on signals and corresponding frequency components and in improving power amplifier behavior

Masked Conditional Neural Networks for Sound Recognition

Sound recognition has been studied for decades to grant machines the human hearing ability. The advances in this field help in a range of applications, from industrial ones such as fault detection in machines and noise monitoring to household applications such as surveillance and hearing aids. The problem of sound recognition like any pattern recognition task involves the reliability of the extracted features and the recognition model. The problem has been approached through decades of crafted features used collaboratively with models based on neural networks or statistical models such as Gaussian Mixtures and Hidden Markov models. Neural networks are currently being considered as a method to automate the feature extraction stage together with the already incorporated role of recognition. The performance of such models is approaching handcrafted features. Current neural network based models are not primarily designed for the nature of the sound signal, which may not optimally harness distinctive properties of the signal. This thesis proposes neural network models that exploit the nature of the time-frequency representation of the sound signal. We propose the ConditionaL Neural Network (CLNN) and the Masked ConditionaL Neural Network (MCLNN). The CLNN is designed to account for the temporal dimension of a signal and behaves as the framework for the MCLNN. The MCLNN allows a filterbank-like behaviour to be embedded within the network using a specially designed binary mask. The masking subdivides the frequency range of a signal into bands and allows concurrent consideration of different feature combinations analogous to the manual handcrafting of the optimum set of features for a recognition task. The proposed models have been evaluated through an extensive set of experiments using a range of publicly available datasets of music genres and environmental sounds, where they surpass state-of-the-art Convolutional Neural Networks and several hand-crafted attempts

Fuzzy Logic

The capability of Fuzzy Logic in the development of emerging technologies is introduced in this book. The book consists of sixteen chapters showing various applications in the field of Bioinformatics, Health, Security, Communications, Transportations, Financial Management, Energy and Environment Systems. This book is a major reference source for all those concerned with applied intelligent systems. The intended readers are researchers, engineers, medical practitioners, and graduate students interested in fuzzy logic systems

ECG Biofeedback

Diplomová práce se věnuje možnostem měření tepové frekvence ze signálu EKG a jejímu využití v terapeutické hře EKG biofeedbacku. V práci je uveden způsob měření EKG pomocí akviziční jednotky Biopac a je diskutováno zpracování signálu pro účely měření tepové frekvence – algoritmy detekce QRS komplexu, HRV analýza. Součástí diplomové práce je návrh a realizace terapeutické hry v programovém prostředí Matlab.The master’s thesis is focused on the possibilities of measuring heart rate of ECG signal and its use in therapeutic game of ECG biofeedback. This thesis describes the way of measuring ECG with acquisition unit Biopac and analyzes signal processing for measurement of heart rate – algorithms of QRS detection, HRV analysis. Realisation of therapeutic is designed for applications in Matlab.

Developing new techniques to analyse and classify EEG signals

A massive amount of biomedical time series data such as Electroencephalograph (EEG), electrocardiography (ECG), Electromyography (EMG) signals are recorded daily to monitor human performance and diagnose different brain diseases. Effectively and accurately analysing these biomedical records is considered a challenge for researchers. Developing new techniques to analyse and classify these signals can help manage, inspect and diagnose these signals. In this thesis novel methods are proposed for EEG signals classification and analysis based on complex networks, a statistical model and spectral graph wavelet transform. Different complex networks attributes were employed and studied in this thesis to investigate the main relationship between behaviours of EEG signals and changes in networks attributes. Three types of EEG signals were investigated and analysed; sleep stages, epileptic and anaesthesia. The obtained results demonstrated the effectiveness of the proposed methods for analysing these three EEG signals types. The methods developed were applied to score sleep stages EEG signals, and to analyse epileptic, as well as anaesthesia EEG signals. The outcomes of the project will help support experts in the relevant medical fields and decrease the cost of diagnosing brain diseases