Automated Assessment of the Quality of Phonocardographic Recordings through Signal-to-Noise Ratio for Home Monitoring Applications.

The signal quality limits the applicability of phonocardiography at the patients' domicile. This work proposes the signal-to-noise ratio of the recorded signal as its main quality metrics. Moreover, we define the minimum acceptable values of the signal-to-noise ratio that warrantee an accuracy of the derived parameters acceptable in clinics. We considered 25 original heart sounds recordings, which we corrupted by adding noise to decrease their signal-to-noise ratio. We found that a signal-to-noise ratio equal to or higher than 14 dB warrants an uncertainty of the estimate of the valve closure latencies below 1 ms. This accuracy is higher than that required by most clinical applications. We validated the proposed method against a public database, obtaining results comparable to those obtained on our sample population. In conclusion, we defined (a) the signal-to-noise ratio of the phonocardiographic signal as the preferred metric to evaluate its quality and (b) the minimum values of the signal-to-noise ratio required to obtain an uncertainty of the latency of heart sound components compatible with clinical applications. We believe these results are crucial for the development of home monitoring systems aimed at preventing acute episodes of heart failure and that can be safely operated by naïve users.