An adaptive thresholding method for the wavelet based denoising of phonocardiogram signal

HBNET: A blended ensemble model for the detection of cardiovascular anomalies using phonocardiogram

BACKGROUND

Cardiac diseases are highly detrimental illnesses, responsible for approximately 32% of global mortality [1]. Early diagnosis and prompt treatment can reduce deaths caused by cardiac diseases. In paediatric patients, it is challenging for paediatricians to identify functional murmurs and pathological murmurs from heart sounds.

OBJECTIVE

The study intends to develop a novel blended ensemble model using hybrid deep learning models and softmax regression to classify adult, and paediatric heart sounds into five distinct classes, distinguishing itself as a groundbreaking work in this domain. Furthermore, the research aims to create a comprehensive 5-class paediatric phonocardiogram (PCG) dataset. The dataset includes two critical pathological classes, namely atrial septal defects and ventricular septal defects, along with functional murmurs, pathological and normal heart sounds.

METHODS

The work proposes a blended ensemble model (HbNet-Heartbeat Network) comprising two hybrid models, CNN-BiLSTM and CNN-LSTM, as base models and Softmax regression as meta-learner. HbNet leverages the strengths of base models and improves the overall PCG classification accuracy. Mel Frequency Cepstral Coefficients (MFCC) capture the crucial audio signal characteristics relevant to the classification. The amalgamation of these two deep learning structures enhances the precision and reliability of PCG classification, leading to improved diagnostic results.

RESULTS

The HbNet model exhibited excellent results with an average accuracy of 99.72% and sensitivity of 99.3% on an adult dataset, surpassing all the existing state-of-the-art works. The researchers have validated the reliability of the HbNet model by testing it on a real-time paediatric dataset. The paediatric model's accuracy is 86.5%. HbNet detected functional murmur with 100% precision.

CONCLUSION

The results indicate that the HbNet model exhibits a high level of efficacy in the early detection of cardiac disorders. Results also imply that HbNet has the potential to serve as a valuable tool for the development of decision-support systems that aid medical practitioners in confirming their diagnoses. This method makes it easier for medical professionals to diagnose and initiate prompt treatment while performing preliminary auscultation and reduces unnecessary echocardiograms.

Novel phonocardiography system for heartbeat detection from various locations

The paper presents evaluation of the proposed phonocardiography (PCG) measurement system designed primarily for heartbeat detection to estimate heart rate (HR). Typically, HR estimation is performed using electrocardiography (ECG) or pulse wave as one of the fundamental diagnostic methodologies for assessing cardiac function. The system includes novel both sensory part and data processing procedure, which is based on signal preprocessing using Wavelet Transform (WT) and Shannon energy computation and heart sounds classification using K-means. Due to the lack of standardization in the placement of PCG sensors, the study focuses on evaluating the signal quality obtained from 7 different sensor locations on the subject's chest and investigates which locations are most suitable for recording heart sounds. The suitability of sensor localization was examined in 27 subjects by detecting the first two heart sounds (S1, S2). The HR detection sensitivity related to reference ECG from all sensor positions reached values over 88.9 and 77.4% in detection of S1 and S2, respectively. The placement in the middle of sternum showed the higher signal quality with median of the proper S1 and S2 detection sensitivity of 98.5 and 97.5%, respectively.

A denoising method of ECG signal based on variational autoencoder and masked convolution

Wearable electrocardiogram (ECG) equipment can realize continuous monitoring of cardiovascular diseases, but these devices are more susceptible to interference from various noises, which will seriously reduce the diagnostic correctness. In this work, a novel noise reduction model for ECG signals is proposed based on variational autoencoder and masked convolution. The variational Bayesian inference is conducted to capture the global features of the ECG signals by encouraging the approximate posterior of the latent variables to fit the prior distribution, and we use the skip connection and feature concatenation to realize the information interaction across the channels. To strengthen the connection of local features of the ECG signals, the masked convolution module is used to extract local feature information, which supplement the global features and the noise reduction performance of whole model can be greatly improved. Experiments are carried out on the MIT-BIH arrythmia database, and the results display that the performance metrics of signal-to-noise ratio (SNR) and root mean square error (RMSE) are significantly improved compared with other approaches while causing less signal distortion.

Investigation of Discrete Wavelet Transform Domain Optimal Parametric Approach for Denoising of Phonocardiogram Signal

Phonocardiogram (PCG) signals are contaminated with various noise signals, which hinders the accurate diagnostic interpretation of the signal. Discrete wavelet transform (DWT) is a well-known technique used to remove noise from PCG signals and improve signal quality. The performance of DWT-based denoising depends upon several parameters involved in the process, such as mother wavelets used for decomposition, the number of decomposition levels (DLs), thresholding technique used and the threshold estimation rule followed. In this work, an investigative study is carried out to select the optimal parameter values which give the best denoising performance. The metrics such as mean-square error (MSE), normalized-mean-square error (NMSE), root-mean-square error (RMSE), percentage root-mean-square difference (PRD) and signal-to-noise ratio (SNR) are used to evaluate the performance of the denoising in this study. The results obtained show that the fifth-order Coiflet wavelet is best suited for denoising PCG signals when applied with the soft thresholding (ST) function and rigrsure threshold selection rule. Also, the optimum number of DLs resulting in better performance is level 6. SNR value obtained from the studies shows the efficacy of the parameters selected for denoising. The denoised PCG signals provide accurate information to determine various kinds of heart valve-related disorders (HVDs).

Fetal phonocardiogram signals denoising using improved complete ensemble (EMD) with adaptive noise and optimal thresholding of wavelet coefficients

Although fetal phonocardiogram (fPCG) signals have become a good indicator for discovered heart disease, they may be contaminated by various noises that reduce the signals quality and the final diagnosis decision. Moreover, the noise may cause the risk of the data to misunderstand the heart signal and to misinterpret it. The main objective of this paper is to effectively remove noise from the fPCG signal to make it clinically feasible. So, we proposed a novel noise reduction method based on Improved Complete Ensemble Empirical Mode Decomposition with Adaptive Noise (ICEEMDAN), wavelet threshold and Crow Search Algorithm (CSA). This noise reduction method, named ICEEMDAN-DWT-CSA, has three major advantages. They were, (i) A better suppress of mode mixing and a minimized number of IMFs, (ii) A choice of wavelet corresponding to the study signal proven by the literature and (iii) Selection of the optimal threshold value. Firstly, the noisy fPCG signal is decomposed into Intrinsic Mode Functions (IMFs) by the (ICEEMDAN). Each noisy IMFs were decomposed by the Discrete Wavelet Transform (DWT). Then, the optimal threshold value using the (CSA) technique is selected and the thresholding function is carried out in the detail's coefficients. Secondly, each denoised (IMFs) is reconstructed by applying the Inverse Discrete Wavelet Transform (IDWT). Finally, all these denoised (IMFs) are combined to get the denoised fPCG signal. The performance of the proposed method has been evaluated by Signal to Noise Ratio (SNR), Mean Square Error (MSE) and the Correlation Coefficient (COR). The experiment gave a better result than some standard methods.

An audio processing pipeline for acquiring diagnostic quality heart sounds via mobile phone

Recently, heart sound signals captured using mobile phones have been employed to develop data-driven heart disease detection systems. Such signals are generally captured in person by trained clinicians who can determine if the recorded heart sounds are of diagnosable quality. However, mobile phones have the potential to support heart health diagnostics, even where access to trained medical professionals is limited. To adopt mobile phones as self-diagnostic tools for the masses, we would need to have a mechanism to automatically establish that heart sounds recorded by non-expert users in uncontrolled conditions have the required quality for diagnostic purposes. This paper proposes a quality assessment and enhancement pipeline for heart sounds captured using mobile phones. The pipeline analyzes a heart sound and determines if it has the required quality for diagnostic tasks. Also, in cases where the quality of the captured signal is below the required threshold, the pipeline can improve the quality by applying quality enhancement algorithms. Using this pipeline, we can also provide feedback to users regarding the cause of low-quality signal capture and guide them towards a successful one. We conducted a survey of a group of thirteen clinicians with auscultation skills and experience. The results of this survey were used to inform and validate the proposed quality assessment and enhancement pipeline. We observed a high level of agreement between the survey results and fundamental design decisions within the proposed pipeline. Also, the results indicate that the proposed pipeline can reduce our dependency on trained clinicians for capture of diagnosable heart sounds.

Wavelet based event detection in the phonocardiogram of prolapsed mitral valve

Mitral valve prolapse (MVP) is one of the cardiovascular valve abnormalities that occurs due to the stretching of mitral valve leaflets, which develops in around 2 percent of the population. MVP is usually detected via auscultation and diagnosed with an echocardiogram, which is an expensive procedure. The characteristic auscultatory finding in MVP is a mid-to-late systolic click which is usually followed by a high-pitched systolic murmur. These can be easily detected on a phonocardiogram which is a graphical representation of the auscultatory signal. In this paper, we have proposed a method to automatically identify patterns in the PCG that can help in diagnosing MVP as well as monitor its progression into Mitral Regurgitation. In the proposed methodology the systolic part, which is the region of interest here, is isolated by preprocessing and thresholded Teager-Kaiser energy envelope of the signal. Scalogram images of the systole part are obtained by applying continuous wavelet transform. These scalograms are used to train the convolutional neural network (CNN). A two-layer CNN could identify the event patterns with nearly 100% accuracy on the test dataset with varying sizes (20% - 40% of the entire data). The proposed method shows potential in the quick screening of MVP patients.

Automated Assessment of the Quality of Phonocardographic Recordings through Signal-to-Noise Ratio for Home Monitoring Applications

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.

Pathological discrimination of the phonocardiogram signal using the bispectral technique

Phonocardiography is a dynamic non-invasive and relatively low-cost technique used to monitor the state of the mechanical activity of the heart. The recordings generated by such a technique is called phonocardiogram (PCG) signals. When shown visually, PCG signals can provide more insights of heart sounds for medical doctors. Thus, several approaches have been proposed to analyse these sounds through PCG recordings. However, due to the complexity and the high nonlinear nature of these recordings, a computer-assisted technique based on higher-order statistics HOS is shown to be, among these techniques, an important tool in PCG signal processing. The third-order spectra technique is one of these techniques; known as bispectrum, it can provide significant information to support physicians with an accurate and objective interpretation of heart condition. This technique is implemented and discussed in this paper. The implemented technique is used for the analysis of heart severity on nine different PCG recordings. These are normal, innocent murmur, coarctation of the aorta, ejection click, atrial gallop, opening snap, aortic stenosis, drum rumble, and aortic regurgitation. A unique bispectrum representation is generated for each type of heart sounds signal. Then, based on the bispectrum analysis, fifteen higher-order spectra HOS features such as the bispectral amplitude, the entropies, the moments, and the weighted center are extracted from each PCG record. The obtained HOS-features showed a well-correlated evolution with the increasing importance of heart severity leading therefore to a high potential in discriminating pathological PCG signals. One should know that, generally, classification of pathological PCG signals refers to the distinction between the presence of a pathology from its absence (binary response) while the discrimination considered in this paper provides an analogue response (value) which can vary from one pathology to another in an increasing or decreasing way.

A Wavelet Transform-Based Neural Network Denoising Algorithm for Mobile Phonocardiography

Cardiovascular pathologies cause 23.5% of human deaths, worldwide. An auto-diagnostic system monitoring heart activity, which can identify the early symptoms of cardiac illnesses, might reduce the death rate caused by these problems. Phonocardiography (PCG) is one of the possible techniques able to detect heart problems. Nevertheless, acoustic signal enhancement is required since it is exposed to various disturbances coming from different sources. The most common denoising enhancement is based on the Wavelet Transform (WT). However, the WT is highly susceptible to variations in the noise frequency distribution. This paper proposes a new adaptive denoising algorithm, which combines WT and Time Delay Neural Networks (TDNN). The acquired signal is decomposed by means of the WT using the coif five-wavelet basis at the tenth decomposition level and then provided as input to the TDNN. Besides the advantage of adaptive thresholding, the reason for using TDNNs is their capacity of estimating the Inverse Wavelet Transform (IWT). The best parameters of the TDNN were found for a NN consisting of 25 neurons in the first and 15 in the second layer and the delay block of 12 samples. The method was evaluated on several pathological heart sounds and on signals recorded in a noisy environment. The performance of the developed system with respect to other wavelet-based denoising approaches was validated by the online questionnaire.