Durand Louis-Gilles, Pibarot Philippe
Laboratory of Biomedical Engineering, Institut de recherches cliniques de Montreal, Montreal Quebec, Canada H2W 1R7.
Crit Rev Biomed Eng. 2017;45(1-6):453-509. doi: 10.1615/CritRevBiomedEng.v45.i1-6.170.
The objective of the present paper is to provide a detailed review of the most recent developments in instrumentation and signal processing of digital phonocardiography and heart auscultation. After a short introduction, the paper presents a brief history of heart auscultation and phonocardiography, which is followed by a summary of the basic theories and controversies regarding the genesis of the heart sounds. The application of spectral analysis and the potential of new time-frequency representations and cardiac acoustic mapping to resolve the controversies and better understand the genesis and transmission of heart sounds and murmurs within the heart-thorax acoustic system are reviewed. The most recent developments in the application of linear predictive coding, spectral analysis, time-frequency representation techniques, and pattern recognition for the detection and follow-up of native and prosthetic valve degeneration and dysfunction are also presented in detail. New areas of research and clinical applications and areas of potential future developments are then highlighted. The Final section is a discussion about a multidegree of freedom theory on the origin of the heart sounds and murmurs, which is completed by the authors' conclusion.
本文的目的是对数字心音图和心脏听诊的仪器设备及信号处理的最新进展进行详细综述。在简短的引言之后，本文介绍了心脏听诊和心音图的简史，随后总结了关于心音产生的基本理论及争议。回顾了频谱分析的应用以及新的时频表示法和心脏声学映射在解决这些争议、更好地理解心音和杂音在心脏-胸腔声学系统中的产生及传播方面的潜力。还详细介绍了线性预测编码、频谱分析、时频表示技术以及模式识别在检测和跟踪天然瓣膜及人工瓣膜退变和功能障碍方面的最新进展。接着强调了新的研究领域和临床应用以及未来可能的发展方向。最后一部分是关于心音和杂音起源的多自由度理论的讨论，并给出了作者的结论。
