Deep Learning in Cardiology

The medical field is creating large amount of data that physicians are unable to decipher and use efficiently. Moreover, rule-based expert systems are inefficient in solving complicated medical tasks or for creating insights using big data. Deep learning has emerged as a more accurate and effective technology in a wide range of medical problems such as diagnosis, prediction and intervention. Deep learning is a representation learning method that consists of layers that transform the data non-linearly, thus, revealing hierarchical relationships and structures. In this review we survey deep learning application papers that use structured data, signal and imaging modalities from cardiology. We discuss the advantages and limitations of applying deep learning in cardiology that also apply in medicine in general, while proposing certain directions as the most viable for clinical use.Comment: 27 pages, 2 figures, 10 table

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

Advanced Signal Processing in Wearable Sensors for Health Monitoring

Smart, wearables devices on a miniature scale are becoming increasingly widely available, typically in the form of smart watches and other connected devices. Consequently, devices to assist in measurements such as electroencephalography (EEG), electrocardiogram (ECG), electromyography (EMG), blood pressure (BP), photoplethysmography (PPG), heart rhythm, respiration rate, apnoea, and motion detection are becoming more available, and play a significant role in healthcare monitoring. The industry is placing great emphasis on making these devices and technologies available on smart devices such as phones and watches. Such measurements are clinically and scientifically useful for real-time monitoring, long-term care, and diagnosis and therapeutic techniques. However, a pertaining issue is that recorded data are usually noisy, contain many artefacts, and are affected by external factors such as movements and physical conditions. In order to obtain accurate and meaningful indicators, the signal has to be processed and conditioned such that the measurements are accurate and free from noise and disturbances. In this context, many researchers have utilized recent technological advances in wearable sensors and signal processing to develop smart and accurate wearable devices for clinical applications. The processing and analysis of physiological signals is a key issue for these smart wearable devices. Consequently, ongoing work in this field of study includes research on filtration, quality checking, signal transformation and decomposition, feature extraction and, most recently, machine learning-based methods

Laser-Induced Graphene for Heartbeat Monitoring with HeartPy Analysis

The HeartPy Python toolkit for analysis of noisy signals from heart rate measurements is an excellent tool to use in conjunction with novel wearable sensors. Nevertheless, most of the work to date has focused on applying the toolkit to data measured with commercially available sensors. We demonstrate the application of the HeartPy functions to data obtained with a novel graphene-based heartbeat sensor. We produce the sensor by laser-inducing graphene on a flexible polyimide substrate. Both graphene on the polyimide substrate and graphene transferred onto a PDMS substrate show piezoresistive behavior that can be utilized to measure human heartbeat by registering median cubital vein motion during blood pumping. We process electrical resistance data from the graphene sensor using HeartPy and demonstrate extraction of several heartbeat parameters, in agreement with measurements taken with independent reference sensors. We compare the quality of the heartbeat signal from graphene on different substrates, demonstrating that in all cases the device yields results consistent with reference sensors. Our work is a first demonstration of successful application of HeartPy to analysis of data from a sensor in development

A unified methodology for heartbeats detection in seismocardiogram and ballistocardiogram signals

This work presents a methodology to analyze and segment both seismocardiogram (SCG) and ballistocardiogram (BCG) signals in a unified fashion. An unsupervised approach is followed to extract a template of SCG/BCG heartbeats, which is then used to fine-tune temporal waveform annotation. Rigorous performance assessment is conducted in terms of sensitivity, precision, Root Mean Square Error (RMSE) and Mean Absolute Error (MAE) of annotation. The methodology is tested on four independent datasets, covering different measurement setups and time resolutions. A wide application range is therefore explored, which better characterizes the robustness and generality of the method with respect to a single dataset. Overall, sensitivity and precision scores are uniform across all datasets (p > 0.05 from the Kruskal–Wallis test): the average sensitivity among datasets is 98.7%, with 98.2% precision. On the other hand, a slight yet significant difference in RMSE and MAE scores was found (p < 0.01) in favor of datasets with higher sampling frequency. The best RMSE scores for SCG and BCG are 4.5 and 4.8 ms, respectively; similarly, the best MAE scores are 3.3 and 3.6 ms. The results were compared to relevant recent literature and are found to improve both detection performance and temporal annotation errors

Advances in Wearable Photoplethysmography Applications in Health Monitoring

In the last few years, interest in wearable technology for physiological signal monitoring is rapidly growing, especially during and after the COVID-19 pandemic

Shallow Neural Network for Biometrics from the ECG-WATCH

Applications such as surveillance, banking and healthcare deal with sensitive data whose confidentiality and integrity depends on accurate human recognition. In this sense, the crucial mechanism for performing an effective access control is authentication, which unequivocally yields user identity. In 2018, just in North America, around 445K identity thefts have been denounced. The most adopted strategy for automatic identity recognition uses a secret for encrypting and decrypting the authentication information. This approach works very well until the secret is kept safe. Electrocardiograms (ECGs) can be exploited for biometric purposes because both the physiological and geometrical differences in each human heart correspond to uniqueness in the ECG morphology. Compared with classical biometric techniques, e.g. fingerprints, ECG-based methods can definitely be considered a more reliable and safer way for user authentication due to ECG inherent robustness to circumvention, obfuscation and replay attacks. In this paper, the ECG WATCH, a non-expensive wristwatch for recording ECGs anytime, anywhere, in just 10 s, is proposed for user authentication. The ECG WATCH acquisitions have been used to train a shallow neural network, which has reached a 99% classification accuracy and 100% intruder recognition rate