New automated wavelet analytical system with a cellular phone for recording intercellular phone remote transmitted bileaflet valve sound

The wavelet analytical system developed in our institute can detect a malfunctioning bileaflet valve by analyzing the split interval (SI) of bileaflet valve sound (BLVS) caused by asynchronous closure of both leaflets. However, this system is limited in its clinical application because of the complications of both valve sound recording and analytical protocols. This study established a new system that improved upon these limitations, and evaluated its clinical efficiency and the possibility of intercellular phone remote transmission of BLVS (ICTB). Fifty-one valves in 36 patients with St. Jude Medical bileaflet valve replacement were examined by fluoroscopy, 90 BLVS files (42 mitral and 48 aortic valve files) were recorded, and 1720 individual BLVS recordings in these files were analyzed with the new system. The new system consists of a cellular phone for BLVS recording and an automated algorithm for analysis with the Morlet continuous wavelet transform. ICTB was also investigated clinically. The new system showed great improvement over the original system by simplifying BLVS recording and reducing analysis time by approximately 65%. This system detected two malfunctioning valves with coefficients of variation (CV) for SI below 0.112, a previously proposed criterion for malfunction. ICTB also proved to be a useful BLVS recording method for determining SI. The new system described in this study could eliminate the factors limiting clinical application of the old system, and ICTB was found to be a clinically applicable BLVS recording method.

[1]  M. Jones,et al.  Doppler color flow evaluation of prosthetic mitral valves: experimental epicardial studies. , 1989, Journal of the American College of Cardiology.

[2]  A Gomi.  Improved method for the wave and frequency analysis of the various prosthetic heart valve sounds , 1989 .

[3]  J. Ross,et al.  Clinical and echocardiographic evaluation of the St. Jude cardiac valve prosthesis: follow-up of 126 patients. , 1984, Journal of the American College of Cardiology.

[4]  Hiroshi Sugiki,et al.  Bileaflet mechanical valve sound analysis using a continuous wavelet transform , 2006, Journal of Artificial Organs.

[5]  J. Copeland,et al.  Acoustic analysis of the closing sounds of bileaflet prosthetic valves in a sheep model. , 1991, The Journal of thoracic and cardiovascular surgery.

[6]  Peter Johansen,et al.  Spectral characteristics of mechanical heart valve closing sounds. , 2002, The Journal of heart valve disease.

[7]  J. Gibbs,et al.  Doppler ultrasound of normally functioning mechanical mitral and aortic valve prostheses. , 1988, International journal of cardiology.

[8]  Shigemi Hosogaya,et al.  [Allowable limits of analytical error which can guarantee the reliability of reference intervals for interpretation of clinical laboratory data]. , 2008, Rinsho byori. The Japanese journal of clinical pathology.

[9]  D. B. Tonks,et al.  A study of the accuracy and precision of clinical chemistry determinations in 170 Canadian laboratories. , 1963, Clinical chemistry.

[10]  B. Segal,et al.  Spectroanalytic evaluation of aortic prosthetic valves. , 1974, Chest.

[11]  H. Allen,et al.  Asynchronous leaflet closure in the normally functioning bileaflet mechanical valve. , 1990, American heart journal.

[12]  S. W. Halpern,et al.  Noninvasive in vivo and in vitro study of the St. Jude mitral valve prosthesis. Evaluation using two dimensional and M mode echocardiography, phonocardiography and cinefluoroscopy. , 1982, The American journal of cardiology.

[13]  S Nitta,et al.  Sound spectroanalytic diagnosis of malfunctioning prosthetic heart valve. , 1977, The Tohoku journal of experimental medicine.

[14]  H. Sustaita,et al.  An appreciation of the new St. Jude valvular prosthesis. , 1981, The Journal of thoracic and cardiovascular surgery.

[15]  E. K. Harris,et al.  Biological and analytic components of variation in long-term studies of serum constituents in normal subjects. 3. Physiological and medical implications. , 1970, Clinical chemistry.

[16]  Y. Matsui,et al.  Wavelet analysis of valve closing sound detects malfunction of bileaflet mechanical valve , 2008, Journal of Artificial Organs.

[17]  E. K. Harris,et al.  Biological and analytic components of variation in long-term studies of serum constituents in normal subjects. II. Estimating biological components of variation. , 1971, Clinical chemistry.

[18]  Kenji Matsuzaki,et al.  Wavelet analysis of bileaflet mechanical valve sounds , 2006, Journal of Artificial Organs.

[19]  M Tanaka,et al.  Real-time sound spectroanalysis for diagnosis of malfunctioning prosthetic valves. , 1980, The Journal of thoracic and cardiovascular surgery.

[20]  George Z. Williams,et al.  Biological and Analytic Components of Variation in Long-Term Studies of Serum Constituents in Normal Subjects I. Objectives, Subject Selection, Laboratory Procedures, and Estimation of Analytic Deviation , 1970 .