Lee David Hojun, Seo Jung-Hee, Mittal Rajat
Department of Mechanical Engineering, Johns Hopkins University, 3400 N Charles Street, Baltimore, MD 21218.
J Biomech Eng. 2023 Feb 1;145(2). doi: 10.1115/1.4055513.
The effect of body habitus on auscultation of heart murmurs is investigated via computational hemoacoustic modeling. The source of the heart murmur is first obtained from a hemodynamic simulation of blood flow through a stenosed aortic valve. This sound source is then placed at the aortic valve location in four distinct human thorax models, and the propagation of the murmur in each thorax model is simulated by solving the elastic wave equations in the time-domain. Placing the same sound source in different thorax models allows for the disambiguation of the effect of body habitus on cardiac auscultation. The surface acceleration resulting from the murmur on each subject's chest surface shows that subjects with higher body-mass index and thoracic cross-sectional area yield smaller acceleration values for the S1 sound. Moreover, the spectral analysis of the signal shows that slope from linear regression in the normal heart sound frequency range (10-150 Hz) is larger for children at the aortic, pulmonic, and mitral auscultation points compared to that for adults. The slope in the murmur frequency range (150-400 Hz) was larger for female subjects at the mitral point compared to that for male subjects. The trends from the results show the potential of the proposed computational method to provide quantitative insights regarding the effect of various anatomical factors on cardiac auscultation.
通过计算血液声学模型研究体型对心脏杂音听诊的影响。心脏杂音的声源首先从通过狭窄主动脉瓣的血流动力学模拟中获得。然后将该声源放置在四个不同的人体胸部模型的主动脉瓣位置,并通过求解时域中的弹性波方程来模拟每个胸部模型中杂音的传播。将相同的声源放置在不同的胸部模型中,可以消除体型对心脏听诊的影响。每个受试者胸部表面因杂音产生的表面加速度表明,体重指数和胸部横截面积较高的受试者,其S1声音的加速度值较小。此外,信号的频谱分析表明,在正常心音频率范围(10 - 150Hz)内,儿童在主动脉、肺动脉和二尖瓣听诊点的线性回归斜率比成人的大。在杂音频率范围(150 - 400Hz)内,女性受试者在二尖瓣点的斜率比男性受试者的大。结果趋势表明,所提出的计算方法有潜力提供关于各种解剖因素对心脏听诊影响的定量见解。