The auscultation of heart sounds has been for decades a fundamental diagnostic tool in clinical practice. Higher effectiveness can be achieved by recording the corresponding biomedical signal, namely the phonocardiographic signal, and processing it by means of traditional signal processing techniques. An unavoidable processing step is the heart sound segmentation, which is still a challenging task from a technical viewpoint—a limitation of state-of-the-art approaches is the unavailability of trustworthy techniques for the detection of heart sound components. The aim of this work is to design a reliable algorithm for the identification and the classification of heart sounds’ main components. The proposed methodology was tested on a sample population of 24 healthy subjects over 10-min-long simultaneous electrocardiographic and phonocardiographic recordings and it was found capable of correctly detecting and classifying an average of 99.2% of the heart sounds along with their components. Moreover, the delay of each component with respect to the corresponding R-wave peak and the delay among the components of the same heart sound were computed: the resulting experimental values are coherent with what is expected from the literature and what was obtained by other studies.

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The signal quality limits the applicability of phonocardiography at the patients’ domicile. This work proposes the signal-to-noise ratio of the recorded signal as its main quality metrics. Moreover, we define the minimum acceptable values of the signal-to-noise ratio that warrantee an accuracy of the derived parameters acceptable in clinics. We considered 25 original heart sounds recordings, which we corrupted by adding noise to decrease their signal-to-noise ratio. We found that a signal-to-noise ratio equal to or higher than 14 dB warrants an uncertainty of the estimate of the valve closure latencies below 1 ms. This accuracy is higher than that required by most clinical applications. We validated the proposed method against a public database, obtaining results comparable to those obtained on our sample population. In conclusion, we defined (a) the signal-to-noise ratio of the phonocardiographic signal as the preferred metric to evaluate its quality and (b) the minimum values of the signal-to-noise ratio required to obtain an uncertainty of the latency of heart sound components compatible with clinical applications. We believe these results are crucial for the development of home monitoring systems aimed at preventing acute episodes of heart failure and that can be safely operated by naïve users.

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The home monitoring of patients affected by chronic heart failure (CHF) is of key importance in preventing acute episodes. Nevertheless, no wearable technological solution exists to date. A possibility could be offered by Cardiac Time Intervals extracted from simultaneous recordings of electrocardiographic (ECG) and phonocardiographic (PCG) signals. Nevertheless, the recording of a good-quality PCG signal requires accurate positioning of the stethoscope over the chest, which is unfeasible for a naïve user as the patient. In this work, we propose a solution based on multi-source PCG. We designed a flexible multi-sensor array to enable the recording of heart sounds by inexperienced users. The multi-sensor array is based on a flexible Printed Circuit Board mounting 48 microphones with a high spatial resolution, three electrodes to record an ECG and a Magneto-Inertial Measurement Unit. We validated the usability over a sample population of 42 inexperienced volunteers and found that all subjects could record signals of good to excellent quality. Moreover, we found that the multi-sensor array is suitable for use on a wide population of at-risk patients regardless of their body characteristics. Based on the promising findings of this study, we believe that the described device could enable the home monitoring of CHF patients soon.