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AUTOMATIC AUSCULTATION USING VISUAL DOT PATTERN

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Journal of Seybold Report ISSN NO: 1533-9211

AUTOMATIC AUSCULTATION USING VISUAL DOT PATTERN

Monali More1, Rajveer Shastri2, Aparna Shastri3

1
monali.more@vpkbiet.org2rajveer.shastri@vpkbiet.org3aparna.shastri@vpkbiet.org
Vidya Pratishthan’s Kamalnayan Bajaj Institute of Engineering & Technology, Baramati,
Savitribai Phule Pune University, Pune, India

Abstract
Auscultation, listening to sounds coming from human organs, is the first routine for
screening and diagnosing many pathological conditions of the heart. Heart sounds-
based diagnosis algorithms are based on the relationships between heart sounds and
heart disease. Most of the conventional methods for diagnosis used time and
frequency domain representation for heart sounds.
This paper describes a Visual dot pattern (VDP) method, which visualizes sound
signals in a diagrammatic representation. Simulations are carried out to evaluate the
algorithms for heart sound analysis under various normal and abnormal conditions.
Principal Component Analysis (PCA) based on the eigenspace system, is used as a
classifier for image patterns obtained. Heart Sound signals patterns are successfully
recognized as normal and abnormal Heart Sound, such as Aortic Stenosis (AS),
Mitral Stenosis (MS), Aortic Regurgitation (AR), and Mitral Regurgitation (MR)
with 83.33% accuracy of Visual Dot Pattern.
Keywords: Auscultation, Heart Sound, Visual Dot Pattern (VDP), Eigen Image,
Principal Component Analysis (PCA).

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1. Introduction
Heart auscultation (the monitoring of sounds produced by the heart and blood circulation) is
a fundamental tool in the diagnosis of heart disease. Auscultation method provides the
information related to each part of the heart. Auscultation is being used to diagnose many
cardiac pathological conditions for a long time. When there are abnormalities present in the
cardiac valves or problems in the tissues of the heart, the cardiac pattern differs from the
usual waveform and produces abnormal sounds in between called murmurs. As living
standards have significantly improved in modern society, the morbidity and mortality rates
of cardiovascular diseases have been rising worldwide. Heart disease now poses an
increasing threat to human health and the quality of life. Based on the state of the mechanical
movement of the heart and the cardiovascular system, the heart sound contains the
physiological and pathological information related to each part of the body.These signals can
be captured and analysed based on spectral characteristics [1].
The noise and distortion that occur in heart sounds is reliable information for early
diagnosis of coronary heart disease. The mechanical activities of the heart, which happen
during each cardiac cycle, produce the sounds, which are known as heart sounds. The
activities due to which these heart sounds are generated are as follows.

(1) The movement of the blood through the chambers of the heart.
(2) The movements of cardiac muscle.
(3) The movement of the valves of the heart. [2]
The human heart generates four sounds during its activity for one cardiac cycle. As shown in
Fig. 1. These sounds identified as S1, S2, S3, and S4 are not all audible.

Fig. 1. Heart sound signals

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S1 is generated at the end of atrial contraction, just at the onset of ventricular contraction. S1
can be heard obviously in the interval of the fifth rib, which lies in the midline of the left
clavicle. The main feature of S1 is low tone and a long time lasted. S2 occurs during
ventricular diastole and can be heard clearly at the auscultation region between the aortic
valve and pulmonary valve. In contrast with S1, it has characteristics of high tune and a short
time lasted. S1 and S2 contain important information of cardiac sounds auscultation [3]. The
third heart sound (S3), occurs just after S2. It is known as the "ventricular gallop", arises
when the mitral valve opens, allowing the passive filling of the left ventricle. A large amount
of blood striking a very compliant left ventricle produces S3 sound. Spectral domain analysis
[1-3] has been carried out for heart sound analysis earlier. This paper explores use of Visual
dot pattern used in fault diagnosis of internal combustion engines by Jian-Da Wu [4]. Their
work included four faults in an engine, five faults in the cooling fan, and three faults in the
drive axle shaft under different conditions were evaluated using the visual dot pattern
technique.
In this paper, image patterns are obtained by Visual Dot Pattern (VDP) to identify the
acoustic signals for heart sound analysis. VDP image patterns of different heart sounds are
obtained, and these patterns are used as a database. Principal Component Analysis used as a
classifier for image patterns obtained. The simulation results indicate that the proposed
technique is effective in heart sound analysis. Heart Sound signals patterns are successfully
recognized as normal and abnormal Heart Sound.

2. Visual Dot Pattern

Vibration signals generated by heartbeat can be represented as the superposition of sinusoidal
signal. The proposed visual dot pattern is method for visually expressing the problem in easy
to understand figure. It involves the transformation of sound pattern into a set of dots having
mirror symmetry, in which the time waveform of the sound signal is visualized as a
snowflake shaped pattern of six-fold symmetry [5].
VDP is a dot pattern obtained by transforming the correlation of value Y(t) of the time-axis
signal at time t and its value Y(t+τ) at time t+τ into polar coordinates P(A(i), ϕ(i), Ѳ(i)) and
drawing a plot. Fig. 2 shows the technique for plotting VDP. One set of data (Y(t), Y(t+τ)) is
plotted to be linearly symmetrical about the initial line of the polar coordinate graph. A
figure symmetrical about a point is created by repeatedly rotating the axis of linear symmetry
and plotting. The transform from the discrete signal y(i) at a fixed sampling time Δt to polar
coordinates P(i) is given by the following equations [6].

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Fig. 2. Principle of Visual Dot Pattern

The algorithm maps normalized time waveform into the visual dot space creating a scatter
plot of neighbour amplitudes on the polar graph. The point in time waveform is mapped into
a radial component and the adjacent point is mapped to the angular component [6].
In plot coordinates P (A(i), Θ(i), Φ(i)), the time lag 'k'¸ and the gain 'g' are taken as
parameters, so, the discriminability of a fault with VDP depends on ¸'k' and 'g'. Fig.4. shows
the effect of frequency on VDP. Higher the frequency of signal more will be overlapping of
dots making unable to discriminate between them. At the lower frequency we get better VDP
pattern as compared to a higher frequency, as shown in Fig.3. So this method is a more
suitable for heart sound signal as its range is from 30Hz to 800Hz. The effect of the time lag
coefficient on VDP is as shown in Figure 4. The time lag coefficient has exactly the inverse
effect on VDP with respect to that of the frequency. It means that time lag coefficient 'k'
should be more ( k=5), so as to minimize the overlapping of dots.
VDP of high discriminability having a wide discriminability high of VDP wide a having
always contour ys obtained by setting ¸ time lag coefficient ‘k’ to 5 and gain value should be
in a range of 25º to 30º pattern the visualized to as so clearly without overlapping. If the gain
is less than 25 or more than VDP pattern becomes unclear as shown in Fig.5.

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(a) f=100 Hz (b) f=300Hz

( c) f=500Hz
(d) f=700Hz

Fig.3. VDP pattern of sine wave with different frequency.

(a) k=1 (b) k=2

(c) k=4 (d) k=5

Fig. 4. Effect of time lag coefficient on VDP

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Fig. 5. Effect of gain value on VDP

VDP patterns of normal heart sound with different beat rate. Change in beat rate has shown
significant variation in corresponding VDP as shown in Fig. 6.

(a)Innocent (b)Normal sinus rhythm

60bpm

(c)Normal sinus rhythm (d)Normal sinus rhythm

90bpm 130bpm

Fig. 6. VDP patterns of Normal heart sound with different beat rate.

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Figure 7 shows the VDP patterns of abnormal HS Aortic (AR namely Aortic Regurgitation),
(AS Aortic Mitral (MR Stenosis), (MS Regurgitation), Mitral Stenosis).

Fig. 7. VDP patterns of abnormal HS (a) AR (b) AS (c) MS

Figure 6 and 7 shows VDP of normal and abnormal heart sound by which we can easily
visualized the difference between them. The input signal Y (t) is first normalizes to the range
through finding the high (ymax) and low (ymin) values for ‘i’ points of data in the window,
so the overall amplitude is not a factor in the characterization. VDP functions somewhat like
autocorrelator and is also sensitive to general frequency content and waveform variability
[7]. These VDP are computed for sample of about two second duration.

3. Principal Component Analysis

Principal component analysis (PCA) uses an orthogonal transformation. It converts a set of
observations of possibly correlated variables into a set of values of uncorrelated variables
called principal components. The number of principal components is less than or equal to the
number of original variables. The first principal component has as high a variance as
possible which represents variability in the data. Each succeeding component has the highest
variance possible under the constraint that it be uncorrelated with the preceding components.
If the data set is jointly normallydistributed, Principal components are guaranteed to be
independent [8]. This algorithm follows two phases: 1) training phase and 2) recognition
phase. In the training phase, the samples of data, are used to create an Eigen Matrix that
transforms the samples in the image space into the points eigenspace. The image samples are

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taken as grayscale images and are transformed from a 2D matrix to a 1D column vector of
size N2×1 by placing the image matrix columns consecutively. These column vectors of n
images are placed column-wise to form the data matrix (image set) X of dimension N2×n.
And m be the mean vector of data vectors in matrix X given by

(5)

The vector of data matrix X is centered by subtracting the mean vector m from all the column
vectors of X to get the covariance matrix Ω of the
column vectors and is given by
Ω=XX’ (6)

The eigenvalues and corresponding eigenvectors are computed for the covariance matrix

ΩV=ᴧV (7)

Where V is the set of eigenvectors associated with the Eigenvalues ᴧ. Set the order of the
eigenvectors vi ε V according to their corresponding eigenvalues from high to low. This
matrix of eigenvectors eigenspace V. The data matrix X is projected onto the eigenspace to
get P consisting n columns, where
P= (8)
In the Recognition phase, the image I to be recognized is converted to 1D vector and form J,
as mentioned above, projected on the same eigenspace to get Z.
Z = Xt (9)
And the Euclidean distance d between Z and all the projected samples in P is measured using
norm (Euclidean distance) of an image A and image B is

(10)
The test image is compared to every training image and the training image that is found to
be nearest to the test image is used to identify the training image [9]

4. Results and Discussion

Simulations are conducted using MATLAB to compare the performance of PCA and the
proposed method. The methods are implemented on grayscale images of fifty different Heart
Sound patterns obtained from VDP. The image patterns obtained from VDP for five different
classes namely Aortic regurgitation, Aortic stenosis, Mitral Stenosis, Mitral regurgitation and
Normal Heart Sound. Each class contains ten image pattern. Fig.9. shows five classes, each
consisting of three different samples. All image cycles taken as grayscale images and
transformed 2D matrix to 1D column vector.Eigenvalues and corresponding Eigenvector are
computed for the data matrix. Then Eigenvectors are set according to their corresponding

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eigenvalues from high to low to get eigenspace. Fig 10 shows the plot of eigenvalues set in
descending order.

Fig. 8. Database of PCA

Fig. 9. Eigen Value Plot

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Fig. 10. Eigen Images

Table 1 Euclidian distance

CLASS Stored Images Euclidian distance
1 AR1_1 12813.671
AR1_2 12569.5368
AR1_3 4678.328527
AS2_1 8429.208762
2 AS2_2 9834.658764
AS2_3 9.42E-11
3 MS3_1 8381.621126
MS3_2 8307.267163
MS3_3 8827.616575
4 MR4_1 8468.854151
MR4_2 8938.147179
MR4_3 7265.517391
5 NR5_1 5302.510014
NR5_2 6472.362705
NR5_3 7707.893251

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This matrix of eigenvectors is nothing but eigenspace. The data matrix is projected onto the
eigenspace. Fig 10 shows eigen images indicating principal component. In the recognition
phase, any random image pattern from the dataset is considered as test image.The Euclidean
distance between the test image and all projected samples is calculated. Table 1 shows the
Euclidean distance between this test image and all projected images.Euclidean distance of
test image is compared with Euclidean distance of projected image, and the test image is
classified into class with closer Euclidean distance. Table 1 indicate that test image i.e.
AS2_3 has minimum Euclidean distance. So the result indicates the test image belongs to
class-2 i.e. Aortic Stenosis.

5. Results and Discussion

Most conventional methods for analyzing the heart sound signals are primarily based on
observing the amplitude difference of the time or frequency domain. This system uses fifty
heart sound divided into the five classes. Each class contains ten heart sounds. VDP has been
applied to all heart sounds to get corresponding image patterns at two sampling frequencies
Fs=44 KHz and Fs=8 KHz. These image patterns applied to PCA Classifier give 83.33%
accuracy. With VDP distinguishing heart sound as normal/abnormal into classes as Aortic
regurgitation, Aortic stenosis, Mitral Stenosis, Mitral regurgitation and Normal Heart Sound.
Also this method gives 100% accuracy for two diseases, namely aortic stenosis and mitral
stenosis.
VDP is simple the diagrammatic representation of signal. It is effective to analyze heart
sound through visualization of sound signals. As VDP is the picture of the polar plot,
pictures become rapidly identified, tabled, remembered & integrated into a coherent whole.
VDP can make differences visible even to nonmedical persons.

Nomenclatures

i No. of dots with time t,

N Number of discrete signal
A(i) Radius of polar plot
y(i) ith sound signal
ymax Maximum sound Signal
ymin Minimum sound signal
g Gain of plotting angle

Greek Symbols
Θ Rotation angle of initial line
Θ(i) Angle of dot in summarized dot pattern
ɸ(i) Negative angle of dot in summarized dot pattern

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