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

Review of neural modelling on cardiovascular rehabilitation active processes by using cycloergometers

Abstract publicado en EUROSIM 2019 Abstract Volume. ARGESIM Report 58, ISBN: 978-3-901608-92-6 (ebook), DOI: 10.11128/arep.58This work gathers important developments carried out in a specific area of the Biomedical Engineering which applies advanced models based on Artificial Neural Networks to improve Cardiovascular Rehabilitation (CR) processes by using Cycloergometers. This work presents an updated revision of proposals, focusing on different problems involved in CR and considering features and requirements nowadays taken into account during their modelling processes. Furthermore, the signals analysed in these models are studied and presented below. Among them, a review of solutions applied to CR processes, focused on Computational Intelligence are cited.UPV/EHU, Grupo de Investigación de Inteligencia Computaciona

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

PRESENT AND FUTURE PERVASIVE HEALTHCARE METHODOLOGIES: INTELLIGENT BODY DEVICES, PROCESSING AND MODELING TO SEARCH FOR NEW CARDIOVASCULAR AND PHYSIOLOGICAL BIOMARKERS

The motivation behind this work comes from the area of pervasive computing technologies for healthcare and wearable healthcare IT systems, an emerging field of research that brings in revolutionary paradigms for computing models in the 21st century. The aim of this thesis is focused on emerging personal health technologies and pattern recognition strategies for early diagnosis and personalized treatment and rehabilitation for individuals with cardiovascular and neurophysiological diseases. Attention was paid to the development of an intelligent system for the automatic classification of cardiac valve disease for screening purposes. Promising results were reported with the possibility to implement a new screening strategy for the diagnosis of cardiac valve disease in developing countries. A novel assistive architecture for the elderly able to non-invasively assess muscle fatigue by surface electromyography using wireless platform during exercise with an ergonomic platform was presented. Finally a wearable chest belt for ECG monitoring to investigate the psycho-physiological effects of the autonomic system and a wearable technology for monitoring of knee kinematics and recognition of ambulatory activities were characterized to evaluate the reliability for clinical purposes of collected data. The potential impact in the clinical arena of this research would be extremely important, since promising data show how such emerging personal technologies and methodologies are effective in several scenarios to early screening and discovery of novel diagnostic and prognostic biomarkers

Acoustic sensing as a novel approach for cardiovascular monitoring at the wrist

Cardiovascular diseases are the number one cause of deaths globally. An increased cardiovascular risk can be detected by a regular monitoring of the vital signs including the heart rate, the heart rate variability (HRV) and the blood pressure. For a user to undergo continuous vital sign monitoring, wearable systems prove to be very useful as the device can be integrated into the user's lifestyle without affecting the daily activities. However, the main challenge associated with the monitoring of these cardiovascular parameters is the requirement of different sensing mechanisms at different measurement sites. There is not a single wearable device that can provide sufficient physiological information to track the vital signs from a single site on the body. This thesis proposes a novel concept of using acoustic sensing over the radial artery to extract cardiac parameters for vital sign monitoring. A wearable system consisting of a microphone is designed to allow the detection of the heart sounds together with the pulse wave, an attribute not possible with existing wrist-based sensing methods. Methods: The acoustic signals recorded from the radial artery are a continuous reflection of the instantaneous cardiac activity. These signals are studied and characterised using different algorithms to extract cardiovascular parameters. The validity of the proposed principle is firstly demonstrated using a novel algorithm to extract the heart rate from these signals. The algorithm utilises the power spectral analysis of the acoustic pulse signal to detect the S1 sounds and additionally, the K-means method to remove motion artifacts for an accurate heartbeat detection. The HRV in the short-term acoustic recordings is found by extracting the S1 events using the relative information between the short- and long-term energies of the signal. The S1 events are localised using three different characteristic points and the best representation is found by comparing the instantaneous heart rate profiles. The possibility of measuring the blood pressure using the wearable device is shown by recording the acoustic signal under the influence of external pressure applied on the arterial branch. The temporal and spectral characteristics of the acoustic signal are utilised to extract the feature signals and obtain a relationship with the systolic blood pressure (SBP) and diastolic blood pressure (DBP) respectively. Results: This thesis proposes three different algorithms to find the heart rate, the HRV and the SBP/ DBP readings from the acoustic signals recorded at the wrist. The results obtained by each algorithm are as follows: 1. The heart rate algorithm is validated on a dataset consisting of 12 subjects with a data length of 6 hours. The results demonstrate an accuracy of 98.78%, mean absolute error of 0.28 bpm, limits of agreement between -1.68 and 1.69 bpm, and a correlation coefficient of 0.998 with reference to a state-of-the-art PPG-based commercial device. A high statistical agreement between the heart rate obtained from the acoustic signal and the photoplethysmography (PPG) signal is observed. 2. The HRV algorithm is validated on the short-term acoustic signals of 5-minutes duration recorded from each of the 12 subjects. A comparison is established with the simultaneously recorded electrocardiography (ECG) and PPG signals respectively. The instantaneous heart rate for all the subjects combined together achieves an accuracy of 98.50% and 98.96% with respect to the ECG and PPG signals respectively. The results for the time-domain and frequency-domain HRV parameters also demonstrate high statistical agreement with the ECG and PPG signals respectively. 3. The algorithm proposed for the SBP/ DBP determination is validated on 104 acoustic signals recorded from 40 adult subjects. The experimental outputs when compared with the reference arm- and wrist-based monitors produce a mean error of less than 2 mmHg and a standard deviation of error around 6 mmHg. Based on these results, this thesis shows the potential of this new sensing modality to be used as an alternative, or to complement existing methods, for the continuous monitoring of heart rate and HRV, and spot measurement of the blood pressure at the wrist.Open Acces

Biometrics

Biometrics uses methods for unique recognition of humans based upon one or more intrinsic physical or behavioral traits. In computer science, particularly, biometrics is used as a form of identity access management and access control. It is also used to identify individuals in groups that are under surveillance. The book consists of 13 chapters, each focusing on a certain aspect of the problem. The book chapters are divided into three sections: physical biometrics, behavioral biometrics and medical biometrics. The key objective of the book is to provide comprehensive reference and text on human authentication and people identity verification from both physiological, behavioural and other points of view. It aims to publish new insights into current innovations in computer systems and technology for biometrics development and its applications. The book was reviewed by the editor Dr. Jucheng Yang, and many of the guest editors, such as Dr. Girija Chetty, Dr. Norman Poh, Dr. Loris Nanni, Dr. Jianjiang Feng, Dr. Dongsun Park, Dr. Sook Yoon and so on, who also made a significant contribution to the book

Signal processing and analytics of multimodal biosignals

Ph. D. ThesisBiosignals have been extensively studied by researchers for applications in diagnosis, therapy, and monitoring. As these signals are complex, they have to be crafted as features for machine learning to work. This begs the question of how to extract features that are relevant and yet invariant to uncontrolled extraneous factors. In the last decade or so, deep learning has been used to extract features from the raw signals automatically. Furthermore, with the proliferation of sensors, more raw signals are now available, making it possible to use multi-view learning to improve on the predictive performance of deep learning. The purpose of this work is to develop an effective deep learning model of the biosignals and make use of the multi-view information in the sequential data. This thesis describes two proposed methods, namely: (1) The use of a deep temporal convolution network to provide the temporal context of the signals to the deeper layers of a deep belief net. (2) The use of multi-view spectral embedding to blend the complementary data in an ensemble. This work uses several annotated biosignal data sets that are available in the open domain. They are non-stationary, noisy and non-linear signals. Using these signals in their raw form without feature engineering will yield poor results with the traditional machine learning techniques. By passing abstractions that are more useful through the deep belief net and blending the complementary data in an ensemble, there will be improvement in performance in terms of accuracy and variance, as shown by the results of 10-fold validations.Nanyang Polytechni

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

Pattern Recognition

A wealth of advanced pattern recognition algorithms are emerging from the interdiscipline between technologies of effective visual features and the human-brain cognition process. Effective visual features are made possible through the rapid developments in appropriate sensor equipments, novel filter designs, and viable information processing architectures. While the understanding of human-brain cognition process broadens the way in which the computer can perform pattern recognition tasks. The present book is intended to collect representative researches around the globe focusing on low-level vision, filter design, features and image descriptors, data mining and analysis, and biologically inspired algorithms. The 27 chapters coved in this book disclose recent advances and new ideas in promoting the techniques, technology and applications of pattern recognition

Multidimensional embedded MEMS motion detectors for wearable mechanocardiography and 4D medical imaging

Background: Cardiovascular diseases are the number one cause of death. Of these deaths, almost 80% are due to coronary artery disease (CAD) and cerebrovascular disease. Multidimensional microelectromechanical systems (MEMS) sensors allow measuring the mechanical movement of the heart muscle offering an entirely new and innovative solution to evaluate cardiac rhythm and function. Recent advances in miniaturized motion sensors present an exciting opportunity to study novel device-driven and functional motion detection systems in the areas of both cardiac monitoring and biomedical imaging, for example, in computed tomography (CT) and positron emission tomography (PET). Methods: This Ph.D. work describes a new cardiac motion detection paradigm and measurement technology based on multimodal measuring tools — by tracking the heart’s kinetic activity using micro-sized MEMS sensors — and novel computational approaches — by deploying signal processing and machine learning techniques—for detecting cardiac pathological disorders. In particular, this study focuses on the capability of joint gyrocardiography (GCG) and seismocardiography (SCG) techniques that constitute the mechanocardiography (MCG) concept representing the mechanical characteristics of the cardiac precordial surface vibrations. Results: Experimental analyses showed that integrating multisource sensory data resulted in precise estimation of heart rate with an accuracy of 99% (healthy, n=29), detection of heart arrhythmia (n=435) with an accuracy of 95-97%, ischemic disease indication with approximately 75% accuracy (n=22), as well as significantly improved quality of four-dimensional (4D) cardiac PET images by eliminating motion related inaccuracies using MEMS dual gating approach. Tissue Doppler imaging (TDI) analysis of GCG (healthy, n=9) showed promising results for measuring the cardiac timing intervals and myocardial deformation changes. Conclusion: The findings of this study demonstrate clinical potential of MEMS motion sensors in cardiology that may facilitate in time diagnosis of cardiac abnormalities. Multidimensional MCG can effectively contribute to detecting atrial fibrillation (AFib), myocardial infarction (MI), and CAD. Additionally, MEMS motion sensing improves the reliability and quality of cardiac PET imaging.Moniulotteisten sulautettujen MEMS-liiketunnistimien käyttö sydänkardiografiassa sekä lääketieteellisessä 4D-kuvantamisessa Tausta: Sydän- ja verisuonitaudit ovat yleisin kuolinsyy. Näistä kuolemantapauksista lähes 80% johtuu sepelvaltimotaudista (CAD) ja aivoverenkierron häiriöistä. Moniulotteiset mikroelektromekaaniset järjestelmät (MEMS) mahdollistavat sydänlihaksen mekaanisen liikkeen mittaamisen, mikä puolestaan tarjoaa täysin uudenlaisen ja innovatiivisen ratkaisun sydämen rytmin ja toiminnan arvioimiseksi. Viimeaikaiset teknologiset edistysaskeleet mahdollistavat uusien pienikokoisten liiketunnistusjärjestelmien käyttämisen sydämen toiminnan tutkimuksessa sekä lääketieteellisen kuvantamisen, kuten esimerkiksi tietokonetomografian (CT) ja positroniemissiotomografian (PET), tarkkuuden parantamisessa. Menetelmät: Tämä väitöskirjatyö esittelee uuden sydämen kineettisen toiminnan mittaustekniikan, joka pohjautuu MEMS-anturien käyttöön. Uudet laskennalliset lähestymistavat, jotka perustuvat signaalinkäsittelyyn ja koneoppimiseen, mahdollistavat sydämen patologisten häiriöiden havaitsemisen MEMS-antureista saatavista signaaleista. Tässä tutkimuksessa keskitytään erityisesti mekanokardiografiaan (MCG), joihin kuuluvat gyrokardiografia (GCG) ja seismokardiografia (SCG). Näiden tekniikoiden avulla voidaan mitata kardiorespiratorisen järjestelmän mekaanisia ominaisuuksia. Tulokset: Kokeelliset analyysit osoittivat, että integroimalla usean sensorin dataa voidaan mitata syketiheyttä 99% (terveillä n=29) tarkkuudella, havaita sydämen rytmihäiriöt (n=435) 95-97%, tarkkuudella, sekä havaita iskeeminen sairaus noin 75% tarkkuudella (n=22). Lisäksi MEMS-kaksoistahdistuksen avulla voidaan parantaa sydämen 4D PET-kuvan laatua, kun liikeepätarkkuudet voidaan eliminoida paremmin. Doppler-kuvantamisessa (TDI, Tissue Doppler Imaging) GCG-analyysi (terveillä, n=9) osoitti lupaavia tuloksia sydänsykkeen ajoituksen ja intervallien sekä sydänlihasmuutosten mittaamisessa. Päätelmä: Tämän tutkimuksen tulokset osoittavat, että kardiologisilla MEMS-liikeantureilla on kliinistä potentiaalia sydämen toiminnallisten poikkeavuuksien diagnostisoinnissa. Moniuloitteinen MCG voi edistää eteisvärinän (AFib), sydäninfarktin (MI) ja CAD:n havaitsemista. Lisäksi MEMS-liiketunnistus parantaa sydämen PET-kuvantamisen luotettavuutta ja laatua