Normal and abnormal heart sounds in cardiac diagnosis Part I: Systolic sounds

Shaver, James A.; Salerni, Rosemarie; Reddy, P S

doi:10.1016/0146-2806(85)90007-6

Cited by 46 publications

(15 citation statements)

References 98 publications

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“…The amplitude of S1 has been shown to be related to the degree of separation of the mitral valve leaflets, determined by the relative timing of the left atrial and ventricular systole. LV contractility was also shown to be an independent factor determining the amplitude of S1 (23,27). The amplitude of the aortic component of S2 has been shown to be closely related to the peak rate of development of the aortic-to-LV differential pressure gradient (17).…”

Section: Discussionmentioning

confidence: 98%

Respiratory modulation of heart sound morphology

Amit¹,

Shukha²,

Gavriely³

et al. 2009

American Journal of Physiology-Heart and Circulatory Physiology

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Section: Discussionmentioning

confidence: 98%

Respiratory modulation of heart sound morphology

Amit¹,

Shukha²,

Gavriely³

et al. 2009

American Journal of Physiology-Heart and Circulatory Physiology

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“…Left ventricular contractility was also shown to be an independent factor determining the amplitude of S1. 4,25 In this study we have demonstrated significant linear correlation between the acoustic energy of S1 and cardiac index in 7 healthy patients undergoing elective laparoscopic operations. This study complements our previous findings indicating amplitude and sound morphology changes due to intrathoracic pressure changes.…”

Section: Discussionmentioning

confidence: 87%

“…4,25 The computational analysis framework included detailed heart sound morphology analysis and automatic elimination of noisy heart beats via clustering analysis. This novel signal processing and feature extraction method essentially followed and enabled us to delineate a linear relationship between the acoustic amplitude (spectral energy) of S1 and cardiac functionality.…”

Section: Bickel Et Almentioning

confidence: 99%

The Use of Pneumoperitoneum During Laparoscopic Surgery as a Model to Study Pathophysiologic Phenomena: The Correlation of Cardiac Functionality with Computerized Acoustic Indices—Preliminary Data

Bickel

Eitan

Мельник

et al. 2012

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Background: Induction of pneumoperitoneum during laparoscopic surgery leads to diverse cardiovascular changes that can be used as a model to study pathophysiologic phenomena. Application of novel signal processing and figure extraction enabled searching for correlation between various signals and pathophysiologic setting. Our aim was to quantitatively correlate cardiac functionality (as expressed by cardiac output) with the spectral energy of the first heart sound (S1) obtained from the phonocardiogram, during laparoscopic surgery. Patients and Methods: Patients who were scheduled for elective laparoscopic operations were enrolled in the study. Cardiac output was maximally changed during anesthesia and abdominal insufflation and was obtained from the arterial pressure wave (FloTracÔ sensor and VigileoÔ monitor [Edwards Lifesciences Ltd.]). Heart signals were recorded during surgery from each subject by a computerized digital data acquisition system. The automatic analysis of the heart sounds included segmentation that was based on the energy envelope of the heart sounds together with analysis of the electrocardiogram signal. We analyzed the morphology of the sounds using hierarchial cluster analysis to remove those sounds that were not reliably recorded. The magnitude of the amplitude of heart sounds was obtained by using the Hilbert transform for each heartbeat. Statistical analysis was based on linear regression. Results: Following exclusion of 3 patients (mainly because of technical reasons), we were left with 7 patients who demonstrated statistically significant positive correlation between cardiac index and the amplitude of S1 (regression coefficient between 0.4 and 0.9, P < .05). Linear regression analysis was done on the normalized values of all 7 patients and was found to be highly significant. Conclusions:In this study we have demonstrated significant linear correlation between the acoustic amplitude (spectral energy) of S1 and cardiac functionality, through sophisticated computerized analysis, using the pneumoperitoneum model for changing the cardiac output.

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“…In normal subjects, the two components are often separated from each other by 40-80 ms during inspiration and they come close together (< 15 ms interval) during expiration. 16 In patients with pulmonary hypertension, the intensity of P2 is accentuated 14 and the delay of P2 in relation to A2 is increased because of the prolongation of right ventricular systole. 5 15 16 However, the short duration of the A2-P2 SI makes it very difficult for the human ear to estimate quantitatively this parameter and thus the PAP.…”

Section: Discussionmentioning

confidence: 99%

A new, simple, and accurate method for non-invasive estimation of pulmonary arterial pressure

Jie

2002

Heart

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Objective: To develop and validate a new non-invasive method for the estimation of pulmonary arterial pressure (PAP) based on advanced signal processing of the second heart sound. Design: Prospective comparative study. Setting: Referral cardiology centre. Patients: This method was first tested in 16 pigs with experimentally induced pulmonary hypertension and then in 23 patients undergoing pulmonary artery catheterisation. Methods: The heart sounds were recorded at the surface of the thorax using a microphone connected to a personal computer. The splitting time interval between the aortic and the pulmonary components of the second heart sound was measured using a computer assisted spectral dechirping method and was normalised for heart rate. Conclusions: This study shows that this new non-invasive method based on advanced signal processing of the second heart sound provides an accurate estimation of the PAP. P ulmonary arterial hypertension is a frequent and serious complication of several cardiovascular or respiratory diseases that is difficult to assess non-invasively. As the options for treatment of pulmonary hypertension have expanded, the requirement for accurate and non-invasive methods to allow regular and safe estimation of pulmonary arterial pressure (PAP) has increased. Measurement of PAP by Doppler echocardiography provides a high degree of correlation (0.89 < r < 0.97) in comparison with pulmonary artery catheterisation.1-3 However, PAP cannot be estimated by Doppler echocardiography in approximately 50% of patients with normal PAP, 10-20% of patients with increased PAP, and 34-76% of patients with chronic obstructive pulmonary disease because of the absence of tricuspid regurgitation, a weak Doppler signal, or a poor signal to noise ratio (SNR). [1][2][3][4] Moreover, Doppler echocardiography cannot be used to monitor PAP continuously. Consequently, it would be useful to develop other non-invasive methods to allow frequent and accurate measurement of PAP.It is well known that the time interval between the aortic (A2) and the pulmonary (P2) components of the second heart sound (S2), as well as the dominant frequency of P2, are increased in the presence of pulmonary hypertension. [5][6][7] It has therefore been suggested that the A2-P2 splitting interval (SI) may be useful to estimate the PAP. However, the basic relation between the SI and the PAP is not well known. Moreover, the applicability of this acoustic approach is limited because the SI is relatively short (generally 100 ms) and is difficult to measure, especially in patients for whom A2 and P2 are overlapping.7 8 Recently, we have proposed a new approach based on advanced signal processing that can successfully identify and extract overlapping A2 and P2 components from S2 recordings and that can be used to measure the A2-P2 SI accurately.9 10 The objective of this work was to study the relation between the SI measured using this new acoustic method and the PAP measured by catheterisation. This relation was first studied in an animal model desi...

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Normal and abnormal heart sounds in cardiac diagnosis Part I: Systolic sounds

Cited by 46 publications

References 98 publications

Respiratory modulation of heart sound morphology

Respiratory modulation of heart sound morphology

The Use of Pneumoperitoneum During Laparoscopic Surgery as a Model to Study Pathophysiologic Phenomena: The Correlation of Cardiac Functionality with Computerized Acoustic Indices—Preliminary Data

A new, simple, and accurate method for non-invasive estimation of pulmonary arterial pressure

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