title: The unique heart sound signature of children with pulmonary artery hypertension.
abstract: We hypothesized that vibrations created by the pulmonary circulation would create sound like the vocal cords during speech and that subjects with pulmonary artery hypertension (PAH) might have a unique sound signature. We recorded heart sounds at the cardiac apex and the second left intercostal space (2LICS), using a digital stethoscope, from 27 subjects (12 males) with a median age of 7 years (range: 3 months-19 years) undergoing simultaneous cardiac catheterization. Thirteen subjects had mean pulmonary artery pressure (mPAp) < 25 mmHg (range: 8-24 mmHg). Fourteen subjects had mPAp ≥ 25 mmHg (range: 25-97 mmHg). We extracted the relative power of the frequency band, the entropy, and the energy of the sinusoid formants from the heart sounds. We applied linear discriminant analysis with leave-one-out cross validation to differentiate children with and without PAH. The significance of the results was determined with a t test and a rank-sum test. The entropy of the first sinusoid formant contained within an optimized window length of 2 seconds of the heart sounds recorded at the 2LICS was significantly lower in subjects with mPAp ≥ 25 mmHg relative to subjects with mPAp < 25 mmHg, with a sensitivity of 93% and specificity of 92%. The reduced entropy of the first sinusoid formant of the heart sounds in children with PAH suggests the existence of an organized pattern. The analysis of this pattern revealed a unique sound signature, which could be applied to a noninvasive method to diagnose PAH.
authors.affiliation: Department of Computing Science, University of Alberta, Edmonton, Alberta, Canada ; Current address: Electrical and Computer Engineering in Medicine Group, University of British Columbia, and British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elgendi
authors.affiliation: Department of Pediatrics and Pediatric Pulmonary Hypertension Service, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Prashant
authors.initials: P
authors.lastname: Bobhate
authors.affiliation: Department of Pediatrics and Pediatric Pulmonary Hypertension Service, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Shreepal
authors.initials: S
authors.lastname: Jain
authors.affiliation: Department of Pediatrics and Pediatric Pulmonary Hypertension Service, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Long
authors.initials: L
authors.lastname: Guo
authors.affiliation: Department of Pediatrics and Pediatric Pulmonary Hypertension Service, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Shine
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Pediatrics and Pediatric Pulmonary Hypertension Service, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada ; Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rutledge
authors.affiliation: Department of Pediatrics and Pediatric Pulmonary Hypertension Service, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada ; Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada.
authors.forename: Yashu
authors.initials: Y
authors.lastname: Coe
authors.affiliation: School of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Roger
authors.initials: R
authors.lastname: Zemp
authors.affiliation: Department of Computing Science, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Dale
authors.initials: D
authors.lastname: Schuurmans
authors.affiliation: Department of Pediatrics and Pediatric Pulmonary Hypertension Service, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada ; Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada.
authors.forename: Ian
authors.initials: I
authors.lastname: Adatia
keywords: auscultation; congenital heart disease; language recognition; machine learning; pulmonary hypertension