Classification of Aortic Stenosis Using Time–Frequency Features From Chest Cardio-Mechanical Signals

Objectives: This paper introduces a novel method for the detection and classification of aortic stenosis (AS) using the time-frequency features of chest cardio-mechanical signals collected from wearable sensors, namely seismo-cardiogram (SCG) and gyro-cardiogram (GCG) signals. Such a method could potentially monitor high-risk patients out of the clinic. Methods: Experimental measurements were collected from twenty patients with AS and twenty healthy subjects. Firstly, a digital signal processing framework is proposed to extract time-frequency features. The features are then selected via the analysis of variance test. Different combinations of features are evaluated using the decision tree, random forest, and artificial neural network methods. Two classification tasks are conducted. The first task is a binary classification between normal subjects and AS patients. The second task is a multi-class classification of AS patients with co-existing valvular heart diseases. Results: In the binary classification task, the average accuracies achieved are 96.25% from decision tree, 97.43% from random forest, and 95.56% from neural network. The best performance is from combined SCG and GCG features with random forest classifier. In the multi-class classification, the best performance is 92.99% using the random forest classifier and SCG features. Conclusion: The results suggest that the solution could be a feasible method for classifying aortic stenosis, both in the binary and multi-class tasks. It also indicates that most of the important time-frequency features are below 11 Hz.Significance: The proposed method shows great potential to provide continuous monitoring of valvular heart diseases to prevent patients from sudden critical cardiac situations.

[1]  Chenxi Yang,et al.  A feasibility study on a low-cost, smartphone-based solution of pulse transit time measurement using cardio-mechanical signals , 2017, 2017 IEEE Healthcare Innovations and Point of Care Technologies (HI-POCT).

[2]  Agnieszka Wosiak,et al.  Multi-label classification methods for improving comorbidities identification , 2017, Comput. Biol. Medicine.

[3]  Hiroshi Motoda,et al.  Computational Methods of Feature Selection , 2022 .

[4]  Carlo Menon,et al.  Moving toward automatic and standalone delineation of seismocardiogram signal , 2015, 2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[5]  Kouhyar Tavakolian,et al.  Analyzing Seismocardiogram Cycles to Identify the Respiratory Phases , 2017, IEEE Trans. Biomed. Eng..

[6]  Grigorios Tsoumakas,et al.  Multi-Label Classification: An Overview , 2007, Int. J. Data Warehous. Min..

[7]  Omer T. Inan,et al.  Wearable Sensing of Left Ventricular Function , 2017, Mobile Health - Sensors, Analytic Methods, and Applications.

[8]  L. Svensson,et al.  Aortic valve stenosis and regurgitation: an overview of management. , 2008, The Journal of cardiovascular surgery.

[9]  H. Mansy,et al.  Time-Frequency Distribution of Seismocardiographic Signals: A Comparative Study , 2017, Bioengineering.

[10]  Bozena Kaminska,et al.  Estimating Cardiac Stroke Volume from the Seismocardiogram Signal , 2010 .

[11]  Kouhyar Tavakolian,et al.  Ballistocardiography and Seismocardiography: A Review of Recent Advances , 2015, IEEE Journal of Biomedical and Health Informatics.

[12]  Eero Lehtonen,et al.  Gyrocardiography: A New Non-invasive Monitoring Method for the Assessment of Cardiac Mechanics and the Estimation of Hemodynamic Variables , 2017, Scientific Reports.

[13]  Sofienne Mansouri,et al.  A New Method for Cardiac Diseases Diagnosis , 2015 .

[14]  Chenxi Yang,et al.  Utilizing Gyroscopes Towards the Automatic Annotation of Seismocardiograms , 2017, IEEE Sensors Journal.

[15]  Gary H. McClelland,et al.  Data Analysis: A Model Comparison Approach To Regression, ANOVA, and Beyond, Third Edition , 2017 .

[16]  Chenxi Yang,et al.  Pulse Transit Time Measurement Using Seismocardiogram, Photoplethysmogram, and Acoustic Recordings: Evaluation and Comparison , 2017, IEEE Journal of Biomedical and Health Informatics.

[17]  Bram van Ginneken,et al.  A survey on deep learning in medical image analysis , 2017, Medical Image Anal..

[18]  S. Davies,et al.  Progression of valvar aortic stenosis: a long-term retrospective study. , 1991, European heart journal.

[19]  R. Klabunde Cardiovascular Physiology Concepts , 2021 .

[20]  Mozziyar Etemadi,et al.  Wearable ballistocardiogram and seismocardiogram systems for health and performance. , 2018, Journal of applied physiology.

[21]  Tero Koivisto,et al.  Automatic identification of signal quality for heart beat detection in cardiac MEMS signals , 2017, 2017 IEEE EMBS International Conference on Biomedical & Health Informatics (BHI).

[22]  Tero Koivisto,et al.  A smartphone-only solution for detecting indications of acute myocardial infarction , 2017, 2017 IEEE EMBS International Conference on Biomedical & Health Informatics (BHI).

[23]  R. Samworth Optimal weighted nearest neighbour classifiers , 2011, 1101.5783.

[24]  W. Loh,et al.  REGRESSION TREES WITH UNBIASED VARIABLE SELECTION AND INTERACTION DETECTION , 2002 .

[25]  Jack Kreindler,et al.  Implementation of a Home Monitoring System for Heart Failure Patients: A Feasibility Study , 2017, JMIR research protocols.

[26]  Mark D. Huffman,et al.  Heart disease and stroke statistics--2013 update: a report from the American Heart Association. , 2013, Circulation.

[27]  U. Rajendra Acharya,et al.  Application of empirical mode decomposition for analysis of normal and diabetic RR-interval signals , 2015, Expert Syst. Appl..

[28]  Guang-Zhong Yang,et al.  From Wearable Sensors to Smart Implants-–Toward Pervasive and Personalized Healthcare , 2015, IEEE Transactions on Biomedical Engineering.

[29]  Kouhyar Tavakolian,et al.  Accurate and consistent automatic seismocardiogram annotation without concurrent ECG , 2015, 2015 Computing in Cardiology Conference (CinC).

[30]  Arye Nehorai,et al.  A Hidden Markov Model for Seismocardiography , 2017, IEEE Transactions on Biomedical Engineering.

[31]  Svensson Lg,et al.  Aortic valve stenosis and regurgitation: an overview of management. , 2008 .

[32]  Andrea Rossi,et al.  Prevalence of comorbidities and associated cardiac diseases in patients with valve aortic stenosis. Potential implications for the decision-making process. , 2012, International journal of cardiology.

[33]  Nicole D. Aranoff,et al.  A Binary Classification of Cardiovascular Abnormality Using Time-Frequency Features of Cardio-mechanical Signals , 2018, 2018 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[34]  I. Maqsood,et al.  Random Forests and Decision Trees , 2012 .

[35]  Willis J. Tompkins,et al.  A Real-Time QRS Detection Algorithm , 1985, IEEE Transactions on Biomedical Engineering.

[36]  Souhir Chabchoub,et al.  Detection of valvular heart diseases using impedance cardiography ICG , 2017 .

[37]  Philippe Ravaud,et al.  A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease. , 2003, European heart journal.

[38]  Kouhyar Tavakolian,et al.  Automatic Annotation of Seismocardiogram With High-Frequency Precordial Accelerations , 2015, IEEE Journal of Biomedical and Health Informatics.

[39]  Tero Koivisto,et al.  Multiclass Classifier based Cardiovascular Condition Detection Using Smartphone Mechanocardiography , 2018, Scientific Reports.

[40]  Chenxi Yang,et al.  Combined Seismo- and Gyro-Cardiography: A More Comprehensive Evaluation of Heart-Induced Chest Vibrations , 2018, IEEE Journal of Biomedical and Health Informatics.

[41]  R. Piotrowicz,et al.  Usefulness of Seismocardiography for the Diagnosis of Ischemia in Patients with Coronary Artery Disease , 2005, Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc.

[42]  N. Huang,et al.  The empirical mode decomposition and the Hilbert spectrum for nonlinear and non-stationary time series analysis , 1998, Proceedings of the Royal Society of London. Series A: Mathematical, Physical and Engineering Sciences.

[43]  Yoshua Bengio,et al.  Random Search for Hyper-Parameter Optimization , 2012, J. Mach. Learn. Res..

[44]  H. M. Marvin Diseases of the Heart and Blood Vessels: Nomenclature and Criteria for Diagnosis. , 1964 .

[45]  A. O. Bicen,et al.  Novel Wearable Seismocardiography and Machine Learning Algorithms Can Assess Clinical Status of Heart Failure Patients , 2018, Circulation. Heart failure.

[46]  Carlo Menon,et al.  Automatic and Robust Delineation of the Fiducial Points of the Seismocardiogram Signal for Noninvasive Estimation of Cardiac Time Intervals , 2017, IEEE Transactions on Biomedical Engineering.

[47]  Mark D. Huffman,et al.  Executive Summary: Heart Disease and Stroke Statistics—2015 Update A Report From the American Heart Association , 2011, Circulation.

[48]  อนิรุธ สืบสิงห์,et al.  Data Mining Practical Machine Learning Tools and Techniques , 2014 .

[49]  Eero Lehtonen,et al.  Automated Detection of Atrial Fibrillation Based on Time–Frequency Analysis of Seismocardiograms , 2017, IEEE Journal of Biomedical and Health Informatics.

[50]  Heng Tao Shen,et al.  Principal Component Analysis , 2009, Encyclopedia of Biometrics.

[51]  Salim Yusuf,et al.  The World Heart Federation's vision for worldwide cardiovascular disease prevention , 2015, The Lancet.

[52]  Timo Knuutila,et al.  Atrial Fibrillation Detection via Accelerometer and Gyroscope of a Smartphone , 2018, IEEE Journal of Biomedical and Health Informatics.

[53]  James M. Rehg,et al.  Mobile Health: Sensors, Analytic Methods, and Applications , 2017 .

[54]  M. Dolgin,et al.  Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels , 1994 .