An open access database for the evaluation of heart sound algorithms

This is an author-created, un-copyedited version of an article published in Physiological Measurement. IOP Publishing Ltd is not responsible for any errors or omissions in this version of the manuscript or any version derived from it. The Version of Record is available online at https://doi.org/10.1088/0967-3334/37/12/2181In the past few decades, analysis of heart sound signals (i.e. the phonocardiogram or PCG), especially for automated heart sound segmentation and classification, has been widely studied and has been reported to have the potential value to detect pathology accurately in clinical applications. However, comparative analyses of algorithms in the literature have been hindered by the lack of high-quality, rigorously validated, and standardized open databases of heart sound recordings. This paper describes a public heart sound database, assembled for an international competition, the PhysioNet/Computing in Cardiology (CinC) Challenge 2016. The archive comprises nine different heart sound databases sourced from multiple research groups around the world. It includes 2435 heart sound recordings in total collected from 1297 healthy subjects and patients with a variety of conditions, including heart valve disease and coronary artery disease. The recordings were collected from a variety of clinical or nonclinical (such as in-home visits) environments and equipment. The length of recording varied from several seconds to several minutes. This article reports detailed information about the subjects/patients including demographics (number, age, gender), recordings (number, location, state and time length), associated synchronously recorded signals, sampling frequency and sensor type used. We also provide a brief summary of the commonly used heart sound segmentation and classification methods, including open source code provided concurrently for the Challenge. A description of the PhysioNet/CinC Challenge 2016, including the main aims, the training and test sets, the hand corrected annotations for different heart sound states, the scoring mechanism, and associated open source code are provided. In addition, several potential benefits from the public heart sound database are discussed.This work was supported by the National Institutes of Health (NIH) grant R01-EB001659 from the National Institute of Biomedical Imaging and Bioengineering (NIBIB) and R01GM104987 from the National Institute of General Medical Sciences.Liu, C.; Springer, DC.; Li, Q.; Moody, B.; Abad Juan, RC.; Li, Q.; Moody, B.... (2016). An open access database for the evaluation of heart sound algorithms. Physiological Measurement. 37(12):2181-2213. doi:10.1088/0967-3334/37/12/2181S21812213371

Detection of the third and fourth heart sounds using Hilbert-Huang transform

<p>Abstract</p> <p>Background</p> <p>The third and fourth heart sound (S3 and S4) are two abnormal heart sound components which are proved to be indicators of heart failure during diastolic period. The combination of using diastolic heart sounds with the standard ECG as a measurement of ventricular dysfunction may improve the noninvasive diagnosis and early detection of myocardial ischemia.</p> <p>Methods</p> <p>In this paper, an adaptive method based on time-frequency analysis is proposed to detect the presence of S3 and S4. Heart sound signals during diastolic periods were analyzed with Hilbert-Huang Transform (HHT). A discrete plot of maximal instantaneous frequency and its amplitude was generated and clustered. S3 and S4 were recognized by the clustered points, and performance of the method was further enhanced by period definition and iteration tracking.</p> <p>Results</p> <p>Using the proposed method, S3 and S4 could be detected adaptively in a same method. 90.3% of heart sound cycles with S3 were detected using our method, 9.6% were missed, and 9.6% were false positive. 94% of S4 were detected using our method, 5.5% were missed, and 16% were false positive.</p> <p>Conclusions</p> <p>The proposed method is adaptive for detecting low-amplitude and low-frequency S3 and S4 simultaneously compared with previous detection methods, which would be practical in primary care.</p

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

Deteção de patologia cardíaca usando machine learning

Segundo a Organização Mundial da Saúde, as doenças cardiovasculares (DCV) representam 32% do número de mortes no mundo. A redução deste valor pode ser atingida através da deteção precoce que pode levar a um tratamento mais preciso, melhorando a expectativa de vida do paciente. A ausculta cardíaca é a principal técnica utilizada pelos profissionais de saúde para identificar muitas DCV. No entanto, a auscultação dos sons cardíacos é um procedimento difícil, já que muitos sons são fracos e difíceis de detetar, sendo necessário um processo de treino contínuo. Os estetoscópios modernos podem amplificar os sons cardíacos, reduzir o ruído de ambiente, melhorar a percepção do usuário e, mais importante, converter um sinal acústico em digital. Isto permitiu o desenvolvimento de sistemas de decisão assistidos por computador baseados na auscultação. Este documento apresenta uma metodologia que pode detectar automaticamente a existência de DCV através de sons cardíacos obtidos de diferentes partes do coração. Diversas tecnologias foram analisadas, assim como projetos que tentam resolver parte do problema em questão e a partir deles, três alternativas diferentes foram elaboradas e documentadas, assim como a divisão do dataset e métricas a serem usadas nos testes. Essas alternativas visam classificar anomalias na auscultação cardíaca dos pacientes. Vários modelos das duas primeiras alternativas foram implementados e seus resultados apresentados. Também é feita uma comparação entre as experiências desenvolvidas entre si, também com experiências básicas que não utilizam mecanismos inteligentes e com outros trabalhos que tenham o mesmo objetivo. O melhor resultado obtido foi pela primeira abordagem com uma exatidão de 94%, precisão de 81% e recall de 67%.According to World Health Organization, the cardiovascular diseases (CVD) represent 32% of the number of deaths worldwide. Early detection leads to a more accurate treatment plan and improves the patient’s life expectancy. Cardiac auscultation is the main technique used by health professionals to identify many CVD. Nevertheless, heart sound auscultation is a difficult procedure, since it requires continuous training and many heart sounds are faint and hard to detect. However, modern stethoscopes can amplify heart sounds, reduce the environment noise, improve the user’s perception and, more importantly, convert an acoustic signal to a digital one. This allowed, the development of computer assisted decision systems based on auscultation. This document presents a methodology that can automatically detect the existence of CVD through cardiac sounds obtained from different parts of the heart. Several technologies were analysed, as well as projects that try to solve part of the problem in question and from them, three different alternatives were elaborated and documented, as well as the division of test data and the metrics for their evaluation. These alternatives are intended to classify anomalies in patients' cardiac auscultation. Several models of the first two alternatives were implemented and their results presented. A comparison is also made between the experiences developed among themselves, also with basic experiments that do not use intelligent mechanisms and with other works that have the same objective. The best result obtained was by the first approach with an accuracy of 94%, precision of 81% and recall of 67%

Signal processing of heart signals for the quantification of non-deterministic events

<p>Abstract</p> <p>Background</p> <p>Heart signals represent an important way to evaluate cardiovascular function and often what is desired is to quantify the level of some signal of interest against the louder backdrop of the beating of the heart itself. An example of this type of application is the quantification of cavitation in mechanical heart valve patients.</p> <p>Methods</p> <p>An algorithm is presented for the quantification of high-frequency, non-deterministic events such as cavitation from recorded signals. A closed-form mathematical analysis of the algorithm investigates its capabilities. The algorithm is implemented on real heart signals to investigate usability and implementation issues. Improvements are suggested to the base algorithm including aligning heart sounds, and the implementation of the Short-Time Fourier Transform to study the time evolution of the energy in the signal.</p> <p>Results</p> <p>The improvements result in better heart beat alignment and better detection and measurement of the random events in the heart signals, so that they may provide a method to quantify nondeterministic events in heart signals. The use of the Short-Time Fourier Transform allows the examination of the random events in both time and frequency allowing for further investigation and interpretation of the signal.</p> <p>Conclusions</p> <p>The presented algorithm does allow for the quantification of nondeterministic events but proper care in signal acquisition and processing must be taken to obtain meaningful results.</p

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