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仅基于心音识别慢性心力衰竭患者的失代偿发作。

Identification of decompensation episodes in chronic heart failure patients based solely on heart sounds.

作者信息

Susič David, Poglajen Gregor, Gradišek Anton

机构信息

Department of Intelligent Systems, Jožef Stefan Institute, Ljubljana, Slovenia.

Jožef Stefan Postgraduate School, Ljubljana, Slovenia.

出版信息

Front Cardiovasc Med. 2022 Nov 15;9:1009821. doi: 10.3389/fcvm.2022.1009821. eCollection 2022.

Abstract

Decompensation episodes in chronic heart failure patients frequently result in unplanned outpatient or emergency room visits or even hospitalizations. Early detection of these episodes in their pre-symptomatic phase would likely enable the clinicians to manage this patient cohort with the appropriate modification of medical therapy which would in turn prevent the development of more severe heart failure decompensation thus avoiding the need for heart failure-related hospitalizations. Currently, heart failure worsening is recognized by the clinicians through characteristic changes of heart failure-related symptoms and signs, including the changes in heart sounds. The latter has proven to be largely unreliable as its interpretation is highly subjective and dependent on the clinicians' skills and preferences. Previous studies have indicated that the algorithms of artificial intelligence are promising in distinguishing the heart sounds of heart failure patients from those of healthy individuals. In this manuscript, we focus on the analysis of heart sounds of chronic heart failure patients in their decompensated and recompensated phase. The data was recorded on 37 patients using two types of electronic stethoscopes. Using a combination of machine learning approaches, we obtained up to 72% classification accuracy between the two phases, which is better than the accuracy of the interpretation by cardiologists, which reached 50%. Our results demonstrate that machine learning algorithms are promising in improving early detection of heart failure decompensation episodes.

摘要

慢性心力衰竭患者的失代偿发作常常导致计划外的门诊或急诊就诊,甚至住院治疗。在这些发作的症状前阶段进行早期检测,可能会使临床医生能够通过适当调整药物治疗来管理这一患者群体,进而预防更严重的心力衰竭失代偿的发生,从而避免与心力衰竭相关的住院治疗。目前,临床医生通过心力衰竭相关症状和体征的特征性变化,包括心音变化,来识别心力衰竭的恶化。事实证明,后者在很大程度上是不可靠的,因为其解读高度主观,且依赖于临床医生的技能和偏好。先前的研究表明,人工智能算法在区分心力衰竭患者和健康个体的心音方面很有前景。在本手稿中,我们专注于分析慢性心力衰竭患者失代偿期和代偿期的心音。使用两种类型的电子听诊器记录了37例患者的数据。通过结合机器学习方法,我们在两个阶段之间获得了高达72%的分类准确率,这优于心脏病专家的解读准确率,后者为50%。我们的结果表明,机器学习算法在改善心力衰竭失代偿发作的早期检测方面很有前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ce8/9705571/69dd705fb4f3/fcvm-09-1009821-g001.jpg

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