Spectral analysis of the heart sounds in children with and without pulmonary artery hypertension

Elgendi, Mohamed; Bobhate, Prashant; Jain, Shreepal; Guo, Long; Rutledge, John; Coe, Yashu; Zemp, Roger J.; Schuurmans, Dale; Adatia, Ian

doi:10.1016/j.ijcard.2014.02.025

Cited by 23 publications

(33 citation statements)

References 14 publications

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“…However, in this investigation the relative power was calculated by dividing the power of the 21-22-Hz frequency band by the power of the 1-80-Hz frequency band, as suggested by our previous work. 14 Sine wave heart sound replicas Formants (unique heart sound signatures) were extracted by means of sine wave replicas, which distill the sound patterns down to key elements by removing extraneous noise. The audio track of each heart sound recording was transformed into sine wave replicas, as in speech analysis.…”

Section: Relative Power Of the Frequency Bandmentioning

confidence: 99%

The Unique Heart Sound Signature of Children with Pulmonary Artery Hypertension

et al. 2015

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We hypothesized that vibrations created by the pulmonary circulation would create sound like the vocal cords during speech and that subjects with pulmonary artery hypertension (PAH) might have a unique sound signature. We recorded heart sounds at the cardiac apex and the second left intercostal space (2LICS), using a digital stethoscope, from 27 subjects (12 males) with a median age of 7 years (range: 3 months-19 years) undergoing simultaneous cardiac catheterization. Thirteen subjects had mean pulmonary artery pressure (mPAp) < 25 mmHg (range: 8-24 mmHg). Fourteen subjects had mPAp ≥ 25 mmHg (range: 25-97 mmHg). We extracted the relative power of the frequency band, the entropy, and the energy of the sinusoid formants from the heart sounds. We applied linear discriminant analysis with leave-one-out cross validation to differentiate children with and without PAH. The significance of the results was determined with a t test and a rank-sum test. The entropy of the first sinusoid formant contained within an optimized window length of 2 seconds of the heart sounds recorded at the 2LICS was significantly lower in subjects with mPAp ≥ 25 mmHg relative to subjects with mPAp < 25 mmHg, with a sensitivity of 93% and specificity of 92%. The reduced entropy of the first sinusoid formant of the heart sounds in children with PAH suggests the existence of an organized pattern. The analysis of this pattern revealed a unique sound signature, which could be applied to a noninvasive method to diagnose PAH.Keywords: pulmonary hypertension, congenital heart disease, auscultation, machine learning, language recognition. Untreated pulmonary artery hypertension (PAH) is a progressive, fatal disease. 1 It complicates many conditions and may affect up to 100 million people worldwide. 2,3 PAH is difficult to diagnose because symptoms appear late in the disease course and the findings on clinical examination are missed easily.The finding on auscultation of a loud pulmonary component of the second heart sound (S2) in PAH has led to the exploration of phonocardiographic associations between S2 and pulmonary artery pressure (PAp) in the time domain. 4-10 However, precise demarcation, timing, and segmentation of the components of S2 remain challenging. [7][8][9][11][12][13] We have explored instead quantitative information in the frequency domain of heart sounds that distinguish between subjects with and without PAH. 14 The relative power of the frequencies between 21 and 22 Hz of the heart sounds recorded at the second left intercostal space (2LICS) was significantly reduced in subjects with PAH. 14 However, there was a 22% error in detecting PAH. Therefore, by investigating further the recordings in these same subjects, we sought to explore other features of the heart sounds in this specific frequency domain that might contain a unique feature that would identify subjects with PAH.Normal speech patterns have a unique signature related to vocal cord vibration, which can be used, for example, to recognize a speaker as male or female...

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Section: Relative Power Of the Frequency Bandmentioning

confidence: 99%

The Unique Heart Sound Signature of Children with Pulmonary Artery Hypertension

et al. 2015

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“…The diagnostic capabilities of student doctors when equipped with a standard acoustic stethoscope and a Littman 3200 DS were compared and found convincing improvements in diagnostic accuracy in the students using the Littman digital stethoscope . The Littman 3200 in conjunction with computer algorithms has been used effectively for diagnosis in clinical studies to define pathology in the pulmonary artery , specify cardiac murmurs and detect adventitious respiratory sounds in paediatric patients . The Littman DS was also used in the newborn to assess gut motility patterns .…”

Section: M Littman Electronic Model 3200/4000mentioning

confidence: 99%

Digital stethoscopes in paediatric medicine

et al. 2019

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Aim: To explore, synthesise and discuss currently available digital stethoscopes (DS) and the evidence for their use in paediatric medicine.Methods: Systematic review and narrative synthesis of digital stethoscope use in paediatrics following searches of OVID Medline, Embase, Scopus, PubMed and Google Scholar databases.Results: Six digital stethoscope makes were identified to have been used in paediatric focused studies so far. A total of 25 studies of DS use in paediatrics were included. We discuss the use of digital stethoscope technology in current paediatric medicine, comment on the technical properties of the available devices, the effectiveness and limitations of this technology, and potential uses in the fields of paediatrics and neonatology, from telemedicine to computer-aided diagnostics. Conclusion: Further validation and testing of available DS devices is required. Comparisonstudies between different types of DS would be useful in identifying strengths and flaws of each DS as well as identifying clinical situations for which each may be most appropriately suited.

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“…При анализе цифровых фонокардиограмм 27 детей (13 без ЛАГ и 14 с ЛАГ) было выявлено, что по сравнению с лицами с нормальным давлением в легочной артерии у пациентов с ЛАГ тоны сердца, записанные во втором межреберье слева, содержат значительно меньшую отно-сительную мощность в полосе 21-22 Гц [31].…”

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