The duration of normal heart sounds

A Robust and Real-Time Capable Envelope-Based Algorithm for Heart Sound Classification: Validation under Different Physiological Conditions

This paper proposes a robust and real-time capable algorithm for classification of the firstand second heart sounds. The classification algorithm is based on the evaluation of the envelope curveof the phonocardiogram. For the evaluation, in contrast to other studies, measurements on twelveprobands were conducted in different physiological conditions. Moreover, for each measurement theauscultation point, posture and physical stress were varied. The proposed envelope-based algorithmis tested with two different methods for envelope curve extraction: the Hilbert transform andthe short-time Fourier transform. The performance of the classification of the first heart soundsis evaluated by using a reference electrocardiogram. Overall, by using the Hilbert transform,the algorithm has a better performance regarding the F1-score and computational effort. Theproposed algorithm achieves for the S1 classification an F1-score up to 95.7% and in average 90.5 %.The algorithm is robust against the age, BMI, posture, heart rate and auscultation point (exceptmeasurements on the back) of the subjects. The ECG and PCG records are available from the authors.

Automatic heart sound detection in pediatric patients without electrocardiogram reference via pseudo-affine Wigner-Ville distribution and Haar wavelet lifting

Having in mind the availability of electronic stethoscopes, phonocardiograms (PCGs) have become popular for cardiovascular functionality monitoring and signal processing applications. Detection of fundamental heart sounds (HSs), S1s and S2s, is considered to be a crucial step in PCG analysis. Electrocardiogram (ECG), noted as a reference signal, is often synchronously recorded in order to simplify the S1/S2 detection process. Nevertheless, electronic stethoscopes are frequently used without additional ECG equipment. We propose a new algorithm for automatic fundamental HSs detection via: joint time-frequency representation based on pseudo affine Wigner-Ville distribution (PAWVD), Haar wavelet lifting scheme (Haar-LS), normalized average Shannon energy (NASE) and autocorrelation. The performance of the proposed algorithm was calculated on both normal (50) and pathological (75) PCG recordings, eight seconds long each, contributed by 125 different pediatric patients. The algorithm showed relatively high recall (90.41%) and precision (96.39%) rates of S1/S2 detection procedure in a variety of PCG signals, without ECG as a reference. Furthermore, it indicated the ability to overcome splitting within the S1/S2 heart sounds.

Simulation of foetal phonocardiographic recordings for testing of FHR extraction algorithms

A valuable alternative to traditional diagnostic tools, such as ultrasonographic cardiotocography, to monitor general foetal well-being by means of foetal heart rate analysis is foetal phonocardiography, a passive and low cost recording of foetal heart sounds. In this paper, it is presented a simulator software of foetal phonocardiographic signals relative to different foetal states and recording conditions (for example different kinds and levels of noise). Before developing the software, a data collection pilot study was conducted with the purpose of specifically identifying the characteristics of the waveforms of the foetal and maternal heart sounds, since the available literature is not rigorous in this area. The developed software, due to the possibility to simulate different physiological and pathological foetal conditions and recording situations simply modifying some system parameters, can be useful as a teaching tool for demonstration to medical students and others and also for testing and assessment of foetal heart rate extraction algorithms from foetal phonocardiographic (fPCG) recordings. On this purpose, the simulator software was used to test an algorithm developed by the authors for foetal heart rate extraction considering different foetal heart rate parameters and signal to noise ratio values. Our tests demonstrated that simulated fPCG signals are very close to real fPCG recordings.

Investigation of the theory and mechanism of the origin of the second heart sound

To investigate further the origin of the second heart sound we studied human subjects, dogs, and a model in vitro of the cardiovascular system. Intra-arterial sound, pressure, and, where possible, flow and high speed cine (2,000 frames/sec) were utilized. The closure sound of the semilunar valves was of higher amplitude in be ventricles than in their respective arterial cavities. The direction of inscription of the main components of intra-arterial sound were opposite in direction to the components of intraventricular sound. Notches, representative of pressure increments, were noted on the ventricular pressure tracings and were coincident with the components of sound. The amplitude of the closure sound varied with diastolic pressure, but remained unchanged with augmentation of forward and retrograde aortic flow. Cines showed second sound to begin after complete valvular closure, and average leaflet closure rate was constant regardless of pressure. Hence, the semilunar valves, when closed, act as an elastic membrane and, when set into motion, generate compression and expansion of the blood, producing transient pressure changes indicative of sound. The magnitude of the initial stretch is related to the differential pressure between the arterial and ventricular chambers. Sound transients which follow the major components of the second sound appear to be caused by the continuing stretch and recoil of the leaflets. Clinically unexplained findings such as the reduced or absent second sound in calcific aortic stenosis and its paradoxical presence in congenital aortic stenosis may be explained by those observations.

Mitral components of the first heart sound

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Relation of the first and second heart sounds to events in the cardiac cycle

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The Initial Vibrations of the First Heart Sound

The major component of the normal first heart sound is that due to valvular closure. Preceding this there occur low frequency, low amplitude vibrations commonly attributed to auricular systole. It has been shown in this study that such vibrations appear invariably even though the auricles are fibrillating, and in heart block when auricular systole is widely seperated from ventricular systole. It is concluded that the onset of ventricular contraction itself causes these vibrations through mechanisms unrelated to auricular contraction, and prior to the valvular component.