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Heart Sound Analysis

This document provides an overview of heart sound analysis, including the anatomy and physiology of the heart, techniques for analyzing heart sounds as digital signals, and applications of heart sound analysis. Key techniques discussed are segmentation, decomposition using time-frequency representations, feature extraction, and classification of heart sounds. Applications explored are estimating pulmonary and left ventricular pressures, measuring cardiac time intervals, and synchronizing cardiac devices.

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Soham Roy
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0% found this document useful (0 votes)
83 views41 pages

Heart Sound Analysis

This document provides an overview of heart sound analysis, including the anatomy and physiology of the heart, techniques for analyzing heart sounds as digital signals, and applications of heart sound analysis. Key techniques discussed are segmentation, decomposition using time-frequency representations, feature extraction, and classification of heart sounds. Applications explored are estimating pulmonary and left ventricular pressures, measuring cardiac time intervals, and synchronizing cardiac devices.

Uploaded by

Soham Roy
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Heart Sound Analysis:

Theory, Techniques and


Applications
Guy Amit
Advanced Research Seminar
May 2004
2
Outline
Basic anatomy and physiology of the heart
Cardiac measurements and diagnosis
Origin and characteristics of heart sounds
Techniques for heart sound analysis
Applications of heart sound analysis

3
Cardiovascular Anatomy
4
The Electrical System
5
The Mechanical System
6
Modulating Systems
The autonomous nervous system
The hormonal system
The respiratory system
Mechanical factors
Electrical factors
7
Multi-System Interactions
Autnonomous
Nervous
Sysetm
Cardiac
Electrical
System
Cardiac
Mechnical
System
Vascular
Mechnical
System
action potentials
Respiratory
System
(thoracic
pressure)
Hormonal
System
(Epinephrine,
Insulin)
blood flow
contractility
compliance
preload, afterload
pacemaker rate
resistance
compliance
Electroca
rdiogram
Echocard
iogram/
Doppler
Phonocar
diogram
Pressure
wave
arterial pressure
venous pressure
venous return
8
Multi-Signal
Correlations
Ventricular pressure
Aortic pressure
Atrial pressure
Aortic blood flow
Venous pulse
Electrocardiogram
Phonocardiogram
Berne R.M., Levy M.N.,
Cardiovascular Physiology, 6
th
edition
9
Heart Disease
Heart failure
Coronary artery disease
Hypertension
Cardiomyopathy
Valve defects
Arrhythmia
10
Cardiac Measurements
Volumes:
Cardiac output CO=HR*SV
Stroke volume SV=LVEDV-LVESV
Ejection fraction EF=SV/LVEDV
Venous return
Pressures:
Left ventricular end-diastolic pressure (preload)
Aortic pressure (afterload)
Time intervals:
Pre-ejection period
Left ventricular ejection time

11
Cardiac Diagnosis
Invasive
Right heart catheterization (Swan-Ganz)
Angiography
Non-invasive
Electrocardiography
Echocardiography
Impedance cardiography
Auscultation & palpitation
12
Heart Sounds
S1 onset of the ventricular contraction
S2 closure of the semilunar valves
S3 ventricular gallop
S4 atrial gallop
Other opening snap, ejection sound
Murmurs
13
The Origin of Heart Sounds
Valvular theory
Vibrations of the heart
valves during their closure
Cardiohemic theory
Vibrations of the entire
cardiohemic system: heart
cavities, valves, blood

Rushmer, R.F., Cardiovascular
Dynamics, 4yh ed. W.B. Saunders,
Philadelphia, 1976
14
Audibility of Heart Sounds
Rushmer, R.F., Cardiovascular Dynamics, 4yh ed. W.B.
Saunders, Philadelphia, 1976
15
Heart Sounds as Digital Signals
Low frequency
S1 has components in 10-140Hz bands
S2 has components in 10-400Hz bands
Low intensity
Transient
50-100 ms
Non-stationary
Overlapping components
Sensitive to the transducers properties and
location
16
Sub-Components of S1
Rushmer, R.F., Cardiovascular Dynamics Obaidat M.S., J. Med. Eng. Tech., 1993
17
Sub-Components of S2
Obaidat M.S., J. Med. Eng. Tech., 1993
18
Heart Sound Analysis Techniques
R.M. Rangayyan, Biomedical Signal Analysis, 2002
19
Segmentation
External references (ECG, CP)
Timing relationship
Spectral tracking
Envelogram
Matching pursuit
Adaptive filtering
20
Decomposition (1)
Non-parametric time-frequency methods:
Linear
Short-Time Fourier Transform (STTF)
Continuous Wavelet Transform (CWT)
Quadratic TFR
Wigner-Ville Distribution (WVD)
Choi-Williams Distribution (CWD)

21
Decomposition (2)
Parametric time-frequency methods:
Autoregressive (AR)
Autoregressive Moving Average (ARMA)
Adaptive spectrum analysis
22
Decomposition - Example
Bentley P.M. et al., IEEE Tran. BioMed. Eng., 1998
WVD
CWD
STFT
CWT
23
Feature extraction
Morphological features
Dominant frequencies
Bandwidth of dominant frequencies (at -3dB)
Integrated mean area above -20dB
Intensity ration of S1/S2
Time between S1 and S2 dominant frequencies
AR coefficients
DWT-based features
24
Classification
Methods:
Gaussian-Bayes
K-Nearest-Neighbor
Artificial Neural-Network
Hidden Markov Model
Rule-based
Classes:
Normal/degenerated bioprosthetic valves
Innocent/pathological murmur
Normal/premature ventricular beat
25
Classification - Example
Durand L.G. et al., IEEE Tran. Biomed Eng., 1990
26
Heart Sound Analysis Applications
Estimation of pulmonary arterial pressure
Estimation of left ventricular pressure
Measurement & monitoring of cardiac time
intervals
Synchronization of cardiac devices

27
Estimation of pulmonary artery
pressure (Tranulis et al., 2002)
Non-invasive method for PAP estimation and
PHT diagnosis
Feature-extraction using time-frequency
representations of S2
Learning and estimation using a neural network
Comparison to invasive measurement and
Doppler-echo estimation
Animal model

28
Signal Processing
Filtering the PCG signal:
100Hz high-pass filter
300Hz low-pass filter
Segmentation of S2 by ECG reference
Decomposition of S2 by TFR:
Smoothed Pseudo-Wigner-Ville distribution
Orthonormal wavelet transform


29
Feature Extraction
SPWVD features:
Maximum instantaneous
frequency of A2,P2
The splitting interval
between A2 and P2
OWT features
(for each scale):
Maximum value
The position of the
maximum value
The energy

30
ANN Training and Testing
A feed-forward, back-propagation
ANN with one hidden layer
The significance of the features
and the size of the network were
evaluated
Training was conducted using 2/3
of the data using error-
minimization procedure
The NN estimations were
averaged for series of beats and
compared to the measured PAP
31
Results
A combination of TFR and OWT features gave the best
results (r=0.89 SEE=6.0mmHg)
The correct classification of PHT from the mean PAP
estimate was 97% (sensitivity 100% ; specificity 93%)
32
Estimation of left ventricular
pressure
PCG and pressure tracing are different
manifestations of cardiac energy
The PCG is proportional to the acceleration
of the outer heart wall => proportional to
the changes of intra-ventricular pressure
S3 is an indication of high filling pressure
or/and stiffening of the ventricular wall
33
Amplitude of S1 and LV dP/dt
Sakamoto T. et al.,
Circ. Res., 1965
34
PCG as a Derivative of Pressure
The transducer
measures acceleration
The acceleration is the
second derivative of
displacement/pressure
Pressure can be
estimated by
integrating the PCG
Heckman J.L., et al., Am. Heart J.,1982
35
Measurement of cardiac time
intervals
LVFT
A2P2
S2
M1T1
S1
S4 S3
OS
EJ
IVRT LVET IVCT
PEP
Systole Diastole
S4
M1T1
S1
36
Synchronization of cardiac assist
devices
Left ventricular assist
device (LVAD)
Intra-aortic balloon
pump
Implantable
Cardioverter Defibrillator
37
Summary
Heart sounds/vibrations represent the
mechanical activity of the cardiohemic
system
The heart sound signal can be digitally
acquired and automatically analyzed
Heart sound analysis can be applied to
improve cardiac monitoring, diagnosis and
therapeutic devices
Thank You !
39
Mathematical Appendix (1)
STFT

CWT

WVD

CWD

t t t e
e
d e t w s t S
t i


=
}
) ( ) ( ) , (
t t t e
e
d e t z t z t S
t i
+ =
}
) 2 ( ) 2 ( ) , (
*
) ( ) ( ) ( t iH t s t z + =
}
= t t d a t g t s a a t S ) ( ) ( 1 ) , (
*
e
t i t
t g
0
2
2
) (
e +
=
t t t
o t
e
e o t
dud u s u s t S
e
t i t u
+ =
}}
)] / 4 /( ) [(
*
2
2 2
) 2 ( ) 2 (
1
) , (
40
Mathematical Appendix (2)
AR

ARMA

Adaptive spectrogram
e
i i i i
f f t t
i
i
i
A f t AS
] ) ( 2 ) / ) [(
2
2 2 2 2
2 ) , (
+

=
to o
o t

=
+ =
p
k
k
n Gx k n y a n y
1
) ( ) ( ) (

= =
+ =
p
k
q
l
l k
l n x b G k n y a n y
1 0
) ( ) ( ) (
41
Mathematical Appendix (3)
SPWVD




OWT

} }


+ = t t t t e
et
d ds s x s x t s g q t S
e
i
] ) 2 ( ) 2 ( ) ( )[ ( ) , (
) 2 ( ) 2 ( ) ( t t t = h h q
}



= ds k s s x j k OWT
j j
) 2 ( ) ( 2 ) , (
2 /

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