The presented algorithm could be used for accurate and non-invasive estimation of cardiac time intervals.
Cardiac time intervals are important hemodynamic indices and provide information about left ventricular performance. Phonocardiography (PCG), impedance cardiography (ICG), and recently, seismocardiography (SCG) have been unobtrusive methods of choice for detection of cardiac time intervals and have potentials to be integrated into wearable devices. The main purpose of this study was to investigate the accuracy and precision of beat-to-beat extraction of cardiac timings from the PCG, ICG and SCG recordings in comparison to multimodal echocardiography (Doppler, TDI, and M-mode) as the gold clinical standard. Recordings were obtained from 86 healthy adults and in total 2,120 cardiac cycles were analyzed. For estimation of the pre-ejection period (PEP), 43% of ICG annotations fell in the corresponding echocardiography ranges while this was 86% for SCG. For estimation of the total systolic time (TST), these numbers were 43, 80, and 90% for ICG, PCG, and SCG, respectively. In summary, SCG and PCG signals provided an acceptable accuracy and precision in estimating cardiac timings, as compared to ICG.
Seismocardiogram (SCG) is the low-frequency vibrations signal recorded from the chest using accelerometers. Peaks on dorsoventral and sternal SCG correspond to specific cardiac events. Prior research work has shown the potential of extracting such peaks for various types of monitoring and diagnosis applications. However, annotation of these peaks is not a trivial task and complicated in some subjects. In this paper, an automated method is proposed to annotate these peaks. The high-frequency accelerations obtained from the same accelerometer, used to record SCG with, were used to facilitate the annotation of the SCG. Algorithms were developed for detection of isovolumic moment (IM) and aortic valve closure (AC) points of SCG. Four different envelope calculation methods were used: cardiac sound characteristic waveform (CSCW), Shannon, absolute, and Hilbert. The algorithms were evaluated based on a dataset including 18 subjects undergoing lower body negative pressure and were further tested with another dataset, which included 67 subjects. These datasets had been previously manually annotated. The algorithm based on CSCW envelope calculation produced the highest detection accuracy for both IM and AC. The overall CSCW algorithm detection accuracy for the test dataset was 98.7% and 99.1% for the IM and AC points, respectively.
We propose a hidden Markov model approach for processing seismocardiograms. The seismocardiogram morphology is learned using the expectation-maximization algorithm, and the state of the heart at a given time instant is estimated by the Viterbi algorithm. From the obtained Viterbi sequence, it is then straightforward to estimate instantaneous heart rate, heart rate variability measures, and cardiac time intervals (the latter requiring a small number of manual annotations). As is shown in the conducted experimental study, the presented algorithm outperforms the state-of-the-art in seismocardiogram-based heart rate and heart rate variability estimation. Moreover, the isovolumic contraction time and the left ventricular ejection time are estimated with mean absolute errors of about 5 [ms] and [Formula: see text], respectively. The proposed algorithm can be applied to any set of inertial sensors; does not require access to any additional sensor modalities; does not make any assumptions on the seismocardiogram morphology; and explicitly models sensor noise and beat-to-beat variations (both in amplitude and temporal scaling) in the seismocardiogram morphology. As such, it is well suited for low-cost implementations using off-the-shelf inertial sensors and targeting, e.g., at-home medical services.
Seismocardiography (SCG) is the measurement of vibrations in the sternum caused by the beating of the heart. Precise cardiac mechanical timings that are easily obtained from SCG are critically dependent on accurate identification of fiducial points. So far, SCG annotation has relied on concurrent ECG measurements. An algorithm capable of annotating SCG without the use any other concurrent measurement was designed. We subjected 18 participants to graded lower body negative pressure. We collected ECG and SCG, obtained R peaks from the former, and annotated the latter by hand, using these identified peaks. We also annotated the SCG automatically. We compared the isovolumic moment timings obtained by hand to those obtained using our algorithm. Mean ± confidence interval of the percentage of accurately annotated cardiac cycles were [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text] for levels of negative pressure 0, -20, -30, -40, and -50 mmHg. LF/HF ratios, the relative power of low-frequency variations to high-frequency variations in heart beat intervals, obtained from isovolumic moments were also compared to those obtained from R peaks. The mean differences ± confidence interval were [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text] for increasing levels of negative pressure. The accuracy and consistency of the algorithm enables the use of SCG as a stand-alone heart monitoring tool in healthy individuals at rest, and could serve as a basis for an eventual application in pathological cases.
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