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

GENERATYWNY MODEL Z DEEP FAKE AUGUMENTATION DLA SYGNAŁÓW Z FONOKARDIOGRAMU ORAZ ELEKTROKARDIOGRAMU W STRUKTURACH LSGAN ORAZ CYCLE GAN

In order to diagnose a range of cardiac conditions, it is important to conduct an accurate evaluation of either phonocardiogram (PCG) and electrocardiogram (ECG) data. Artificial intelligence and machine learning-based computer-assisted diagnostics are becoming increasingly commonplace in modern medicine, assisting clinicians in making life-or-death decisions. The requirement for an enormous amount of information for training to establish the framework for a deep learning-based technique is an empirical challenge in the field of medicine. This increases the risk of personal information being misused. As a direct result of this issue, there has been an explosion in the study of methods for creating synthetic patient data. Researchers have attempted to generate synthetic ECG or PCG readings. To balance the dataset, ECG data were first created on the MIT-BIH arrhythmia database using LS GAN and Cycle GAN. Next, using VGGNet, studies were conducted to classify arrhythmias for the synthesized ECG signals. The synthesized signals performed well and resembled the original signal and the obtained precision of 91.20%, recall of 89.52% and an F1 score of 90.35%.W celu zdiagnozowania szeregu chorób serca, istotne jest przeprowadzenie dokładnej oceny danych z fonokardiogramu (PCG) i elektrokardiogram (EKG). Sztuczna inteligencja i diagnostyka wspomagana komputerowo, oparta na uczeniu maszynowym stają się coraz bardziej powszechne we współczesnej medycynie, pomagając klinicystom w podejmowaniu krytycznych decyzji. Z kolei, Wymóg ogromnej ilości informacji do trenowania, w celu ustalenia platformy (ang. framework) techniki, opartej na głębokim uczeniu stanowi empiryczne wyzwanie w obszarze medycyny. Zwiększa to ryzyko niewłaściwego wykorzystania danych osobowych. Bezpośrednim skutkiem tego problemu był gwałtowny rozwój badań nad metodami tworzenia syntetycznych danych pacjentów. Badacze podjęli próbę wygenerowania syntetycznych odczytów diagramów EKG lub PCG. Stąd, w celu zrównoważenia zbioru danych, w pierwszej kolejności utworzono dane EKG w bazie danych arytmii MIT-BIH przy użyciu struktur sieci generatywnych LSGAN i Cycle GAN. Następnie, wykorzystując strukturę sieci VGGNet, przeprowadzono badania, mające na celu klasyfikację arytmii na potrzeby syntetyzowanych sygnałów EKG. Dla wygenerowanych sygnałów, przypominających sygnał oryginalny uzyskano dobre rezultaty. Należy podkreślić, że uzyskana dokładność wynosiła 91,20%, powtarzalność 89,52% i wynik F1 – odpowiednio 90,35%

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

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

Physiological system modelling and clinical simulation for diagnosis

Chapter 0 Contains the thesis introduction thesis and concepts of NDIs, derivations and applications. It also summarizes the PNDIs that are derived in the subsequent chapters. Chapter 1 Introduces the concept of using Physiological Non-Dimensional Indexes (PNDI) for distinguishing or classifying patients who were diabetic from non-diabetic and those who are the risk of becoming diabetic. In the authors work, he has also demonstrated that those who were diabetic were actually at-risk and those who were normal were in fact at the rim of becoming diabetic. All the works were verified against with clinical data by parametric identification techniques. Chapter 2 Using the findings of the above chapter, the author conceptualized, and design and simulated a dynamic activity-based insulin infusion system. He has used the clinical data of diabetic patients in the above chapter for demonstrating the operations of the system. He has even demonstrated the stability of the system by having continual simulations till 4-hour. Chapter 3 In this chapter, the author has derived a series of system equations for identification of pulmonary diseases based in the inhale and exhale gas mixtures concentrations and volume space. Chapter 4 In this chapter, the author has derived a series of system equations for identification of diseased lungs based of the lungs’ pressurevolume graphs. He has even demonstrated the techniques of obtaining the Cardiac Output (CO) non-invasively. Chapter 5 The author has demonstrated how to obtain the relative urine outflow non-invasively for normal kidneys. Chapter 6 The author has described the significance and derivation background of PNDI

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