Diagnosis Of Pulmonary Stenosis By Using FFT Analysis Of Heart Sounds

Mr. Yadnesh Sanzgiry

Department Of Electronics & Telecommunication Goa College Of Engineering. Farmagudi, Ponda Goa
ysanzgiry@gmail.com

Prof. Dr. R. B. Lohani

Head of Department Department Of Electronics & Telecommunication Goa College Of Engineering. Farmagudi, Ponda - Goa
rblohani@gec.ac.in

Mr. Anil Raikar

Senior Research Scientist Philips India Bangalore Karnataka
anil.raikar@philips.com

Abstract In this paper we investigate the possibility of heart defect diagnosis by fast fourier transform analysis of heart sounds. Heart Auscultation is defined as the process of interpreting acoustic waves produced by the mechanical action of the heart. The tools used by physicians to listen to the heart sounds is known as a stethoscope. Pulmonary Stenosis is a narrowing of the pulmonary artery or the pulmonary valve causing an obstruction (blockage) of blood flow out of the right ventricle to the lungs.

(constricts) these valve leaflets spread apart easily allowing the blood to flow out of the heart and to the lungs. Pulmonary valve stenosis is a heart valve disorder that involves the pulmonary valve. This valve separates the right ventricle (one of the chambers in the heart) and the pulmonary artery. The pulmonary artery carries oxygen-poor blood to the lungs. Stenosis occurs when the valve cannot open wide enough. As a result, less blood flows to the lungs. If the pulmonary valve or pulmonary artery is small, or if the pulmonary valve leaflets are not formed normally, blood flow out of the heart may be more difficult or blocked (refer Fig 1).

I.

INTRODUCTION

Cardiovascular diseases are the leading cause of death in developing countries. Being a disease tightly connected to aging, it is observed that its incidence is on the rising due to the extended life expectancy. Auscultation is a technique in which a stethoscope is used to listen to the sounds of a body. Especially it is important for listening to the sounds of heart, in which the structural defects of the heart are often reflected and physician can usually make use of them. When they listen to the heart sound (HS), the physicians are particularly interested in abnormal sounds, which may suggest the presence of cardiac pathology and also provide diagnostic information. It is very difficult for the physician to make a diagnosis straightly according to the auscultation information because of the complexity and variability of HS and the limitation of the traditional auscultation technique. Normal heart sounds have two major components called the first heart sound (S1) and the second heart sound (S2). If there is a problem with one of the heart valves, erroneous sounds can be heard in either systole or diastole phase. In severe cases, the other sounds can completely dominate and distort S1 or S2 and are indicators of valvular cardiac disorder. They make a heart sound different from normal and a trained physician can identify and associate a particular cardiac disorder. The normal pulmonary valve consists of three (3) thin and flexible valve leaflets. When the right ventricle contracts

Figure 1 Pulmonary valve stenosis

Narrowing in the pulmonary valve is usually present at birth (congenital). It is caused by a problem that occurs when the unborn baby (fetus) is developing. The cause is unknown, but genetics may play a role. The defect may occur alone or with other congenital heart defects. The condition can be mild or severe. Pulmonary valve stenosis is a rare disorder. Narrowing that occurs in the valve itself is called pulmonary valve stenosis. There may also be narrowing just before or just after the valve.

The degree of stenosis is typically determined by the peak pressure gradient across the valve.[1] Pulmonary stenosis is mild if the valve area is larger than 1.0 cm2 per square meter and the trans-valvular gradient is 50-80 mmHg, or the peak RV systolic pressure is less than 75 mmHg. The stenosis is moderate if valve area is 0.5-1.0 cm2 per square meter, transvalvular gradient is 50-80 mmHg, or right ventricle systolic pressure is 75-100 mmHg. It is severe when the valve area is less than 0.5 cm2, and the gradient is more than 80 mmHg. II.
DATA

These sound samples can be further processed in the frequency domain using Fast Fourier transforms or FFT. The Fourier Transform (FT) is effective when applied to analysis of stationary signals. However, FT assumes stationarity of the signal and provides only frequency information of the signal, but not in the time domain. Therefore, it has severe limitations when the characteristics of the signal to be analyzed are strongly time-dependent.

Heart sound signals reflects the mechanical movement of the heart and cardiovascular system, which contains physiological and pathological information of every part of heart and interactions among them[4]. The frequency range of heart sound is 0.1~800Hz, while regular measuring range is about 20~600Hz[5] . The heart sound detection system should be able to apply to this range to ensure accuracy and reliability. Heart sound signals and its characteristics Heart sound is the signal transmitted through the chest wall and surrounding tissue that caused by the mechanical vibration in the cardiac cycle as a result of the systolic and diastolic of myocardial, open and close of gate valve, blood washed the ventricular wall and main artery[1]. Typical heart sound signals is shown in Fig2, generally the heart sound signals including the first heart sound (S1), the second heart sound (S2) and no audible murmurs. In some cases, the third heart sound (S3) and fourth heart sound (S4) can also be detected.

Figure 3 Normal heart sound in the time domain

Figure 2. Typical heart sound signals waveform

Figure 4 Pulmonary stenosis sound in the time domain

Samples obtained from heart sound databases were normal heart sounds, mild pulmonary stenosis and severe pulmonary stenosis. The test data was in .wav format. Amplitudes of the test data were computed using MATLAB 7.0 A clear distinction can be observed between the normal heart sound in Fig 3 and that with Pulmonary Stenosis in Fig 4.

In order to gain information from both time and frequency domains, Dennis Gabor (1946) adapted the Fourier transform to analyze only a small section of the signal at a time. This adaptation is called the Short-Time Fourier Transform (STFT). The STFT is formally defined by the integral transform:

III.

FAST FOURIER TRANSFORM

Fourier Transform is a kind of signal representation which makes use of infinitely supported sinusoidal signals where the time localization of the signal is not achieved. STFT or a windowed fourier transform provides some degree of localization, but the resolution is fixed. Fig 5 Shows the FFT of a normal heart sound. As observed the peak occurs at 120Hz. Now observing Fig 6 we see that the sound with pulmonary stenosis has its peak at 194 Hz.

Repeating the above procedure over multiple samples of normal heart sound and that of pulmonary stenosis yielded the following result: Normal Heart Sound : 114Hz to 124 Hz Severe Pulmonary Stenosis : 186 Hz to 196 Hz. V. FUTURE SCOPE

This method of studying the FFT of heart sounds can be performed with more heart sound samples, and hence, other heart valve defects can also be detected. Analyzing the heart sound for the energy of individual coefficients can yield a more detailed analysis of the heart defects. Feature extraction can enable us to correlate various parameters hence making the analysis dynamic in nature. Using wavelets to analyze heart sounds can be taken up thus correlating the frequency peaks with discrete locations of the heart sound. Such an analysis can be concentrated around systolic murmur hence restricting the analysis to ventricular valves.

Figure 5 FFT of a normal heart sound

REFERENCES
[1] Handbook of Echo-Doppler Interpretation. Armonk, NY, U.S.A.: Futura. 1996. pp. 1156. ISBN 0-87993-636-3. [2] Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007. [3] Zhou Jing,Yang Yongming,He Wei. A New Algorithm of Heart Sound Feature Extraction, Chinese Journal of Biomedical Engineering, 2005.6; 24(6):pp.685-689 [4] LiuJun,Jin Chongying,Wang Weilian.Data Recall and Analysis System of Heart Soundsand ECG Signals Based on Labview. Electronic Measurement Technology,2006;29(8):46-48. [5] Zhao.Zhidong,Tang Xianghong,Zao Zhijin. Spectrum Analysis of Heart Sound Based on Hilbert-Huang Transform, Chinese Journal ofSensor and Actuators,2005.1;18(1)pp.18-22 [6] She Ranyon Roston, Electronic Stethoscope SIM University May 2009. [7] Haibin Wang, Jian Chen and Yuliang Hu, Heart Sound Measurement and Analysis 978-1-4244-4134-1/09/$25.00 2009 IEEE [8] S. A. Jawed, M. Gottardi, A. Baschirotto, 1-4244-1001-0/07/$25.00 c2007 IEEE. Conference on Complex Medical Engineering. [9] P. Carvalho, P. Gil, J. Henriques, M. Antunes and L. Eugnio, Low Complexity Algorithm for Heart Sound Segmentation using the Variance Fractal Dimension, in Proc. of Int. Sym. on Intelligent Signal Processing, Algarve, Portugal, Sep 3-7. 2005, pp. 937-942 [10] www.philips .com/datasheets

Figure 6 FFT of a pulmonary stenosis heart sound

IV.

CONCLUSION

[11] Developing Custom Signal Processing Algorithm with LabView FPGA and Compact RIO to Detect the Aortic Stenosis Disease B Al-Naami1, J Chebil1, B Trabsheh1, H Mgdob Hashemite University, Zarqa, Jordan 2University of Sussex, Brighton, UK [16] Design and Implementation of a Remote Embedded DSP Stethoscope with a Method for Judging Heart Murmur Ying-Wen Bai