CN108523920B

CN108523920B - Method for identifying heart murmur type based on multipath heart sounds

Info

Publication number: CN108523920B
Application number: CN201810161705.XA
Authority: CN
Inventors: 边俊杰; 邹文初; 邹旭辉
Original assignee: Henan Shanren Medical Technology Co ltd
Current assignee: Henan Shanren Medical Technology Co ltd
Priority date: 2018-02-26
Filing date: 2018-02-26
Publication date: 2023-08-22
Anticipated expiration: 2038-02-26
Also published as: CN108523920A

Abstract

The heart murmur type identification method based on multipath heart sounds comprises the steps of synchronously collecting and synchronously recording an electrocardiogram and multipath heart sound images, and respectively identifying the electrocardio characteristics of each cardiac cycle; searching heart sound characteristics of each path of heart sound images according to the corresponding of each heart sound characteristic, marking M1 of all heart sound images, marking T1 of all heart sound images, marking A2 of all heart sound images and marking P2 of all heart sound images; systolic murmurs are identified between T1-A2 and diastolic murmurs are identified between P2 and the next M1. The invention has the advantages of automatically identifying heart murmur type and being suitable for household monitoring of heart state.

Description

Method for identifying heart murmur type based on multipath heart sounds

Technical Field

The invention relates to an analysis method of an electrocardiogram and heart sound chart, in particular to an electrocardiogram and heart sound analysis method suitable for household electrocardiogram and heart sound monitoring.

Background

In the human heart, the sinoatrial node automatically and rhythmically generates electrical currents, which are delivered to various parts of the heart in the order of conductive tissue, thereby causing contraction and relaxation of myocardial cells. The excitation from the sinoatrial node is sequentially transferred to the atria and ventricles in a certain way and process, causing excitation of the whole heart. Thus, the direction, path, order, and timing of the electrical changes that occur during excitation of the various parts of the heart are regular. The bioelectric change is reflected to the body surface by the conductivity resistance and body fluid around the heart, so that each part of the body is subjected to regular electric change in every cardiac cycle. The heart electric change curve recorded by the appointed position of the limb or the body by using the guiding motor becomes an electrocardiogram.

The phonocardiogram displays heart sounds and heart extra sounds and murmurs. The phonocardiogram has great effect on judging the form and frequency composition of heart murmurs, can judge the time of heart murmurs and murmurs, clearly distinguish the occurrence sequence of certain heart murmurs, and distinguish continuous murmurs consistent in the heart cycle. There is a tricuspid valve between the right atrium and the right ventricle, a mitral valve between the left atrium and the left ventricle, a pulmonary valve between the right ventricle and the pulmonary artery, and an aortic valve between the left ventricle and the aorta. The right atrium excites, the tricuspid valve opens, blood flow enters the right ventricle, the tricuspid valve closes, the right ventricle excites, and blood flow enters the pulmonary artery. The blood after pulmonary circulation enters the left atrium, the mitral valve opens the blood into the left ventricle, the mitral valve closes, the left ventricle excites, and blood flow enters the aorta. The generation of S1 is related to the closure of the mitral valve (T1) and the tricuspid valve (M1), and the generation of S2 is caused by the closure of the aortic valve (A2) and the pulmonary valve (P2).

The initiating factor of the heart change when the heart potential changes is shown first, the first heart sound S1 is behind the R wave of the electrocardiogram, and the second heart sound S2 is behind the electrocardio repolarization wave (T wave).

The auscultation area of the heart valve usually has five areas, (1) the mitral valve area M is located at the strongest point of the apex beat, also called apex area; (2) pulmonary valve region P, between the 2 nd intercostal of the left sternum; (3) aortic valve area A is right of the heart bottom and is positioned between the 2 nd ribs of the right sternum edge; (4) the second auscultation area E of the aortic valve is the left side of the bottom of the heart, is arranged between the 3 rd rib of the left edge of the sternum and is also called Erb area, and is beneficial to diagnosing the insufficiency of the aortic valve; (5) the tricuspid region T is between the 4 th and 5 th intercostals at the lower left edge of the sternum, i.e. the left edge of the sternum. The auscultation sequence of heart sounds is as follows: (1) mitral valve region M begins- (2) pulmonary valve region P- (3) aortic valve region a- (4) aortic valve second auscultation region E- (5) tricuspid valve region T. Or is: (5) the tricuspid valve region begins- (4) aortic valve second auscultation region- (3) aortic valve region- (2) pulmonary valve region- (1) mitral valve region. The normal heart, the first heart sound is most clear at the apex and the second heart sound is most clear at the base.

In the case of heart murmurs, for some reasons, turbulence and vorticity are generated during the flow of blood in the heart and large blood vessels, and the turbulence and vorticity impact nearby tissues, and cause vibration to generate heart murmurs. Some heart murmurs are limited, some are more extensive, and different heart diseases have their own conduction directions. In most cases, the loudest areas are often the right edge of the upper sternum and the neck, while the loudest areas of mitral insufficiency may be at the apex of the heart. The loudest part and conduction range of the noise are helpful for judging the source of the noise. The direction and extent of transmission of the noise is helpful for the determination of the type of heart disease. However, the direction and range of heart sound transmission can only be used for auscultation of different heart listening positions of a patient one by a doctor, and diagnosis results are completely given by the auscultation skills and experience of the doctor. The manual auscultation method cannot acquire heart sounds of all heart auscultation areas of a patient at the same time, and cannot analyze multi-path heart sound data.

The term interpretation in this application with respect to phonocardiograms and electrocardiographs:

the first heart sound S1, M1 is the first audible component in S1 and T1 is the second audible component in S1. Normally, T1 follows M1, occurring after tricuspid valve closure. Normally the interval between M1 and T1 is 0.02s.

The second heart sound S2, S2 is produced by the closure of the aortic valve (A2) and the pulmonary valve (P2), A2 being the first component of S2, P2 being the second component of S2, P2 being generally audible only in the bottom left part of the heart. Normally, the interval between A2 and P2 is about 0.03S.

Third heart sound S3, S3 occurs after S2 with a probability of 84.4% before age 20; the occurrence probability after 25 years is 46.6%, and S3 is rarely heard over 40 years.

The fourth heart sound S4, S4 occurs before the first heart sound.

From the cardiac cycle, S1-S2 correspond to the systolic phase of the heart and S2-S1 of the next cycle correspond to the diastolic phase of the heart.

In an electrocardiogram, one cardiac cycle includes a P wave, a QRS wave and a T wave, a first heart sound S1 lags behind the P wave, a second heart sound lags behind the T wave, and a QT interval refers to an interval from a coming time of the Q wave to an ending time of the T wave.

Disclosure of Invention

The invention aims to provide a multi-channel heart sound analysis method capable of simultaneously monitoring electrocardio and multi-channel heart sound signals and preliminarily judging the heart sound transmission direction and transmission range.

A method for analyzing multi-path heart sounds, comprising the steps of:

step 1: synchronously acquiring and synchronously recording an electrocardiogram and multiple paths of phonocardiograms, wherein each path of phonocardiograms corresponds to a respective auscultation area, the phonocardiograms are sequentially arranged according to the auscultation areas, the electrocardiogram and all the phonocardiograms use the same time axis, and heart rate is obtained at the same time during electrocardiographic monitoring;

Step 2: acquiring cardiac cycles through heart rates, respectively identifying the electrocardio characteristics of each cardiac cycle, and marking a time axis by using the electrocardio characteristics, wherein the electrocardio characteristics at least comprise R waves and T waves;

step 3: searching heart sound characteristics of each path of heart sound chart according to the corresponding heart sound characteristics, wherein the heart sound characteristics comprise S1 and S2;

step 4: and identifying whether the heart has a lesion or a lesion trend according to the occurrence time of the S1, and/or the intensity of the S1, and/or the time of the S2, and/or the intensity of the S2.

The electrocardiographic features of the electrocardiogram at least comprise an R wave and a T wave, and normally, a first heart sound S1 should appear after the electrocardiographic R wave, and a second heart sound S2 should appear after the electrocardiographic T wave.

The method for determining the electrocardio characteristic R wave comprises the following steps: 1) Acquiring the heart rate of a user, and calculating the average time t of each heart beat, wherein t is taken as the duration of a cardiac cycle;

2) And acquiring an electrocardiogram with a period of time of t from the electrocardiogram as a current electrocardiogram, sampling the current electrocardiogram, acquiring the amplitude of each sampling point, searching the maximum amplitude point of the current electrocardiogram, taking the maximum amplitude point as a current R wave, and recording the moment of the R wave.

The method for determining the electrocardio characteristic T wave comprises the following steps: 3.1 Intercepting an electrocardiogram with the length t from the current R wave backwards to serve as a current electrocardiogram, sampling the current electrocardiogram, obtaining the amplitude of each sampling point, and identifying all wave peaks in the current electrocardiogram, wherein the wave peaks refer to the sampling points with the amplitude larger than that of the adjacent sampling points before and after the current electrocardiogram;

3.2 Searching for the most amplitude value)Large wave peak, judging the time interval T between the wave peak and the current R wave _R1 Whether or not it is smaller than the time interval T between the peak and the current electrocardiographic end time _R2 If yes, taking the peak with the largest amplitude as a T wave, and marking the moment of the T wave.

As a preferable scheme, the electrocardio characteristic also comprises P waves, and the method for determining the P waves comprises the following steps: intercepting an electrocardio graph with the length of T from the current R wave backwards, intercepting a graph after the T wave as a current analysis graph, sampling the current analysis graph to acquire the amplitude of each sampling point, and identifying all wave peaks in the current electrocardio graph, wherein the wave peaks refer to the sampling points with the amplitude larger than that of the adjacent sampling points before and after the current electrocardio graph;

searching the peak with the maximum amplitude, and judging the time interval T between the peak and the current T wave _P1 Whether or not it is greater than the time interval T between the peak and the current electrocardiographic end time _P2 If so, taking the peak with the largest amplitude as the P wave, and taking the previous P wave to the next P wave as a cardiac cycle.

First heart sound S1 and intensity thereof, second heart sound S2 and intensity thereof are identified according to electrocardiographic feature positioning

The heart sound auscultation area at least comprises the apex (M area), the left side of the bottom of the heart (P area), the right side of the bottom of the heart (A area) and the left sternum edge (T area).

The scheme for obtaining the intensity of S1 is as follows: the following operations are performed in each cardiac cycle: acquiring R waves and T waves of an electrocardiogram of a current cardiac cycle, respectively taking graphs of RT intervals as current heart sound graphs for each heart sound graph, sampling the current heart sound graphs to obtain the amplitude of each sampling point, and finding out the sampling point with the maximum amplitude; acquiring an interval T between a maximum amplitude sampling point and R waves _R And the interval T between the maximum amplitude sampling point and the T wave _T Determine whether T _R <T _T If yes, taking the sampling point with the maximum amplitude as S1 of the current cardiac cycle of the current phonocardiogram, and taking the maximum amplitude as the intensity of S1; if not, the sampling frequency is increased, and the step is repeated; by M _S1 Representing the S1 intensity of the M region, expressed as P _S1 S1 intensity representing P region, A _S1 Represents the S1 intensity, T of region A _S1 Representation ofS1 intensity of T region.

The scheme for obtaining the intensity of S2 is as follows: the following operations are performed in each cardiac cycle: acquiring TP intervals between T waves of an electrocardiogram of a current cardiac cycle and P waves of a next cardiac cycle, respectively taking graphs of each TP interval as current heart sound graphs, sampling the current heart sound graphs to obtain the amplitude of each sampling point, and finding out the sampling point with the maximum amplitude; acquiring an interval T between a maximum amplitude sampling point and R waves _R And the interval T between the maximum amplitude sampling point and the T wave _T Determine whether T _R <T _T If yes, taking the sampling point with the maximum amplitude as S2 of the current cardiac cycle of the current phonocardiogram, and taking the maximum amplitude as the intensity of S2; if not, the sampling frequency is increased, and the step is repeated; by M _S2 Representing the S2 intensity of the M region, expressed as P _S2 S2 intensity representing P region, A _S2 Represents S2 intensity, T of region A _S2 The S2 intensity of the T region is indicated.

Heart sound sensor position identification correction method

Sometimes, the heart sound sensors may be placed at the correct auscultation positions one by one, but the heart sound map does not correspond to the auscultation area, for example, the heart sound sensor of the heart sound map in the area a is placed at the auscultation position in the area P, the heart sound sensor of the heart sound map in the area P is placed at the auscultation position in the area T, etc. At this time, it is necessary to identify whether or not the phonocardiogram corresponds correctly to the respective auscultation areas, and if not, it should be adjusted to one-to-one correct correspondence.

Preferably, M is found for each cardiac cycle in turn _S1 ，P _S1 ，A _S1 ，T _S1 MAX of (2) _S1 Determine whether M _S1 ＝MAX _S1 If yes, outputting an M area to be in place; if not, record MAX _S2 The original auscultation area corresponding to the heart sound image is located, and then the heart sound image with the maximum value MAX is marked as an M area; the original M area is marked as the auscultation area to be determined.

Preferably, M is found for each cardiac cycle in turn _S2 ，P _S2 ，A _S2 ，T _S2 MAX of (2) _S2 Determine whether A _S2 ＝MAX _S1 If yes, outputting the zone A to be in place; if not, record MAX _S2 The auscultation area corresponding to the heart sound image is marked as an A area; the original A area is marked as the auscultation area to be determined.

Preferably, if zone M is in place while zone A is in place, it is determined whether P is met _S2 >T _S2 If yes, outputting the P area to be in position and the T area to be in position;

if the M area is in place, the A area is to be determined, and MAX is to be set _S2 The original auscultation area of the heart sound chart is the P area; then judging whether the S2 intensity of the original A area accords with A _S2 >T _S2 If yes, the original A area is marked as a P area, and the T area is unchanged; if not, marking the original T area as a P area, and marking the original A area as a T area;

if the M area is in place, the A area is to be determined, and MAX is to be set _S2 The original auscultation area of the heart sound chart is a T area; then judging whether the S2 intensity of the original A area accords with A _S2 >P _S2 If yes, the original A area is marked as a P area, and the P area is marked as a T area; if not, marking the original A area as a P area, and marking the original P area as a T area;

if zone M is pending, zone A is in place and MAX _S1 The auscultation area of the heart sound chart is a T area; judging whether the S2 intensity of the original M region accords with M _S2 >P _S2 If yes, the original M area is marked as a P area, and the P area is marked as a T area; if not, the original M is marked as a T area;

If zone M is pending, zone A is in place and MAX _S1 The auscultation area of the heart sound chart is the P area; judging whether the S2 intensity of the original M region accords with M _S2 >T _S2 If yes, the original M area is marked as a P area, and the P area is marked as a T area; if not, the original M is marked as a T area;

if the M area is to be determined and the A area is to be determined, judging whether the S2 intensity of the original M area and the S2 intensity of the original A area are consistent with M _S2 >A _S2 If yes, the original M area is marked as a P area, and the original A area is marked as a T area.

Another scheme for identifying whether the positions of the multi-path heart sound sensor are correctly corresponding to auscultation areas

Before monitoring the heart function, it should be confirmed whether the multiple heart sound auscultation heart sound sensors are located in the correct auscultation area.

The heart sound sensor position error correction method for multi-path heart sound auscultation comprises the following steps:

for each cardiac cycle: respectively extracting an S1 graph of each heart sound graph in the current cardiac cycle, and sampling each S1 graph with the same sampling frequency to obtain a maximum forward peak value of each S1 graph; for S1, judging whether the maximum forward peak value of S1 conforming to the M area is larger than the maximum forward peak values of S1 of all other auscultation areas, if so, repeatedly extracting and comparing the maximum forward peak value of S1 in the next cardiac cycle, and if all cardiac cycles conform to the maximum S1 maximum forward peak value of the M area, outputting that the M area is correctly positioned, and continuing the identification of the T area; if the maximum forward peak value of the S1 which does not accord with the M area in the cardiac cycle is the maximum value, outputting the position abnormality of the M area, and checking the position of the heart sound sensor;

When the M area is correctly positioned, an S1 sampling pattern of the M area and an S1 sampling pattern of the T area are obtained, the maximum forward peak point is removed from the S1 sampling pattern of the M area to obtain M area data, the maximum forward peak point is removed from the S1 sampling pattern of the T area to obtain T area data, the M area data and the T area data are overlapped in time, and whether a point exists in the T area data or not is judged, and the forward peak value of the point is larger than all peaks in the M area data; if yes, the S1 of the T area is provided with two components of M1 and T1, and the T area is correctly positioned; if not, outputting the abnormal T area, and checking the position of the heart sound sensor.

Preferably, in step 4, respectively extracting an S2 graph of each heart sound graph in the current cardiac cycle, and sampling each S2 graph with the same sampling frequency to obtain a maximum forward peak value of each S2 graph; the extraction of S1 and S2 is performed synchronously or according to a specified sequence;

judging whether the maximum forward peak value of S2 conforming to the A area is larger than the maximum forward peak value of S2 of all other auscultation areas according to the S2, if conforming, repeatedly extracting and comparing the maximum forward peak value of S2 in the next cardiac cycle, and if conforming to the maximum S2 of the A area in all cardiac cycles, outputting that the A area is correctly positioned, and continuing the identification of the P area; if the maximum positive peak value of S2 which does not accord with the area A in the cardiac cycle is the maximum value, outputting the position abnormality of the area A, and checking the position of a heart sound sensor;

When the A area is correctly positioned, an S2 sampling pattern of the A area and an S2 sampling pattern of the P area are obtained, the maximum forward peak point is removed from the S2 sampling pattern of the A area to obtain data of the A area, the maximum forward peak point is removed from the S2 sampling pattern of the P area to obtain data of the P area, the data of the A area and the data of the P area are overlapped in time, and whether a point exists in the data of the P area or not is judged, and the forward peak value of the point is larger than all peak values in the data of the A area; if yes, the S2 of the P area is provided with two components of A2 and P2, and the P area is correctly positioned; if not, outputting the abnormality of the P area, and checking the position of the heart sound sensor.

The idea of identifying whether the heart sound sensor is correctly positioned is: in heart sound auscultation, the M1 component in S1 is heard at all auscultation sites, but most clearly in the apex M region. And M1 is stronger than T1, so that the S1 amplitude of the apex of the heart is actually the amplitude of M1, and M _S1 Maximum, M, compared with other auscultation areas _S1 The occurrence time is the occurrence time of M1. If the M-region phonocardiogram accords with M _S1 Compared with other auscultation areas, the heart sound map of the M area is indicated to be the largest, and the heart sound map of the M area corresponds to the auscultation area of the M area correctly. If not, the heart sound image of the M area is not corresponding to the auscultation area of the M area.

T1 follows M1, but little energy is generated to T1, which can only be heard in the left sternal edge T region. Thus, in S1 of the T-zone phonocardiogram, M1 and T1, i.e., M, should occur _S1 A distinct peak, i.e. the pulse corresponding to T1, should occur after the moment. If the pulse is not generated, the heart sound image of the T area is not corresponding to the auscultation area of the T area.

The A2 component in S2 can be heard in all auscultation sites, but the best auscultation site is the area A on the right side of the bottom of the heart, and the intensity of A2 is greater than that of P2, so the S2 amplitude of the area A is actually the amplitude of A2, and A _S2 Maximum, A compared with other auscultation areas _S2 The appearance time is the appearance time of A2. If the phonocardiogram of the A region accords with A _S2 Compared with other auscultation areas, the auscultation area A is the largest, and the heart sound chart of the area A corresponds to the auscultation area A correctly. If not, describe the heart sounds in zone AThe graph does not correspond to the auscultation area of area a.

P2 is the second component of S2, and P2 is generally heard only on the left side of the bottom of the heart after A2. Thus, in S2 of the P-zone phonocardiogram, A2 and P2, A, should occur _S2 A distinct peak, i.e. the pulse corresponding to P2, should occur after the moment. If the pulse is not generated, the heart sound image of the P area is not corresponding to the auscultation area of the P area.

And when each phonocardiogram is correctly corresponding to the respective auscultation area, synchronously acquiring the electrocardiogram and the multipath phonocardiograms, and monitoring the heart function.

As a preferred scheme: a method of determining heart sound characteristics M1, T1, A2 and P2, comprising the steps of:

1. R waves are acquired for each cardiac cycle in an electrocardiogram respectively, S1 corresponding to the current R waves on an M-region heart sound chart is acquired, and the occurrence time t of the maximum value of the S1 is acquired _S1 ，t _S1 As the corresponding time of M1, let t _S1 Marking M1 of all phonocardiograms;

2. s2 corresponding to the current T wave on the heart sound chart of the area A is obtained, and the maximum value occurrence time T of the S2 is obtained _S2 ，t _S2 As the corresponding time of A2, let t _S2 A2, marking all phonocardiograms;

3. acquiring T on heart sound chart of T region _S1 Labeled S1, obtaining t _S1 The first distinct peak that appears later, the distinct peak being referred to as the heel t _S1 The amplitude values of the moments are similar, and can be obtained according to statistics of T1 amplitude data, and T is used for _S1 After which the first distinct peak occurs at time t _T1 As the corresponding time of T1, let T be _T1 Marking T1 of all phonocardiograms;

4. acquiring t on P region phonocardiogram _S2 Labeled S2, obtaining t _S2 The first distinct peak that appears later, the distinct peak being referred to as the heel t _S2 The amplitude values of the moments are similar, and can be obtained according to P2 amplitude data statistics, and t is used _S2 Then the first apparent peak occurs at time t _P2 As the corresponding time of P2, let t _P2 P2 of all phonocardiograms is marked.

Further, the method for acquiring the S1 according to the R wave comprises the following steps: obtaining R wave peakTime t at which value occurs _R At t _R The waveform on the phonocardiogram is acquired in a designated time interval and is recorded as S1; the specified time interval is within the RT time interval of the electrocardiogram and the first peak of S1 occurs before the end of the electrocardiographic S wave.

Further, the method for acquiring the S2 according to the T wave comprises the following steps: obtaining the moment T of occurrence of the wave crest of the T wave _T At T _T Then, acquiring waveforms on the phonocardiogram in a given time interval, and recording the waveforms as S2; the given time interval follows the T wave of the electrocardiogram, precedes the P wave of the next cardiac cycle, and the first peak of S2 occurs before the end of the T wave.

The heart function detection includes heart sound splitting, enhancement or weakening, heart murmur and murmur type, and heart murmur transmission direction.

Scheme for identifying heart sound enhancement

After the time axes M1, T1, A2 and P2 are positioned, whether the S1 is split or not can be identified by using the interval time of the M1, T1; using the spacing time of A2 and P2, it can be identified whether S2 splits abnormally. And, after M1, T1, A2 and P2 are located, the amplitude of each point can be obtained to judge whether S1 is enhanced or reduced, and whether S2 is enhanced or reduced.

The scheme for identifying splitting of S1 is as follows: in each phonocardiogram, t is acquired for each cardiac cycle _S1 And t _T1 Is a time interval T of (1) _M-T If T _M-T =0.02S, then S1 is normal natural division; when a heart sound image of a certain area appears T _M-T >0.02S, S1 splits widely and is abnormal.

The scheme for identifying splitting of S2 is as follows: in each phonocardiogram, t is acquired for each cardiac cycle _S2 And t _P2 Is a time interval T of (1) _A-P If T _A-P =0.03S, then S2 is normal natural division; when a heart sound image of a certain area appears T _A-P >0.03S, S2 is split widely and abnormal;

scheme for identifying heart sound enhancement

After the intensity of S1 is obtained, the intensity of S1 is analyzed to learn the trend of the variation of the intensity of S1.

Identifying S1 increases or decreasesThe scheme of (2) is as follows: in the first case, M area phonocardiogram is acquired, and M area t is used in each cardiac cycle _S1 If the amplitude of the moment is compared with the normal amplitude of M1, if the M area t _S1 Amplitude of time of day>M1 is normal in amplitude, and the current cardiac cycle S1 is considered to be enhanced; if M region t _S1 Amplitude of time of day<M1 is normal in amplitude, the current cardiac cycle S1 is considered to be weakened; if M region t _S1 The amplitude of the moment is in a normal range, and the current cardiac cycle S1 is considered to be normal;

in the second case, continuously identifying the S1 amplitude of each cardiac cycle of the M region, and if the S1 of all cardiac cycles is enhanced, outputting the S1 enhancement; outputting S1 alternations of enhancement and attenuation if S1 enhancement and S1 attenuation alternates; if S1 of all cardiac cycles is weakened, then the output S1 is weakened; and if the number of the cycles of S1 enhancement and/or S1 weakening is smaller than a preset value, S1 is considered to be normal.

When S1 is weakened, the S1 intensities in each cardiac cycle are compared respectively, and whether S1 is continuously weakened gradually or weakened irregularly can be found or the S1 intensities are alternately changed from strong to weak to strong to weak.

Since the M region is the optimal auscultation region of S1, the S1 intensity of the M region is preferentially analyzed when analyzing the S1 intensity.

After the intensity of S2 is obtained, the intensity of S2 is analyzed to learn the trend of the variation of the intensity of S2.

The scheme for identifying the enhancement or attenuation of S2 is as follows: in the first case, a heart sound image of the area A is acquired, and in each cardiac cycle, the area A T is used for _S1 If the amplitude of the moment is compared with the normal amplitude of A2, if the area A T _S1 Amplitude of time of day>A2, regarding that the current cardiac cycle S2 is enhanced if the amplitude of the A2 is normal; if zone A T _S2 Amplitude of time of day<A2, regarding that the current cardiac cycle S2 is weakened if the amplitude of the A2 is normal; if zone A T _S2 The amplitude of the moment is in a normal range, and the current cardiac cycle S2 is considered to be normal;

in the second case, continuously identifying the S2 amplitude of each cardiac cycle of the A region, and if the S2 of all cardiac cycles is enhanced, outputting the S2 enhancement; outputting S2 alternations of enhancement and attenuation if S2 enhancement and S2 attenuation alternates; if S2 of all cardiac cycles is weakened, then the output S2 is weakened; and if the number of the cycles of S2 enhancement and/or S2 weakening is smaller than a preset value, S2 is considered to be normal.

When S1 and S2 are continuously and gradually weakened, the heart failure signal is probably generated, and the attention of a user is reminded.

Since zone a is the optimal auscultation zone for S2, the S2 intensity of zone a is preferentially analyzed when analyzing the S2 intensity.

Scheme for recognizing heart murmurs

After M1, T1, A2 and P2 positioning on the time axis, it is possible to identify, for each of the same phonocardiograms, whether there is a noise between S1 and S2, and whether there is a noise between S2 and S1 of the next cardiac cycle.

The method for identifying heart murmurs is as follows:

1) Acquiring a D1 graph between T1 and A2 and a D2 graph between P2 and the next M1 for each cardiac cycle of the phonocardiogram of each auscultation area respectively,

2) Judging whether the up-down fluctuation of the D1 is in a normal range, if so, judging that the systolic period of the current cardiac cycle has no noise, if not, judging that the current cardiac cycle has systolic period noise, and recording the auscultation area, the cardiac cycle and the systolic period noise graph;

3) Judging whether the up-down fluctuation of the D2 is in a normal range, if so, judging that the diastole of the current cardiac cycle is free of noise, otherwise, judging that the diastole of the current cardiac cycle is noise, and recording the auscultation area, the cardiac cycle and the diastole of the current cardiac cycle.

Further, for each systolic period noise figure, the change trend and the maximum value of the pulse peak value in the current systolic period noise figure are identified, when the pulse peak value is weakened or strengthened from S1 to S2, the maximum value is judged to be positioned at the position of the current systolic period noise figure, the maximum value is early-stage systolic noise when being positioned at the front half part, the maximum value is middle-stage systolic noise when being positioned at the middle part, and the maximum value is late-stage systolic noise when being positioned at the rear half part; when the variation trend of the pulse peak value approaches to a straight line, the pulse peak value is a full-systolic noise.

Further, for each diastolic period noise figure, the variation trend and the maximum value of the pulse peak value in the current diastolic period noise figure are identified, when the pulse peak value is weakened or strengthened from S2 to the next S1, the maximum value is judged to be positioned at the current diastolic period noise figure, the maximum value is early diastolic period noise when being positioned at the front half part, the maximum value is middle diastolic period noise when being positioned at the middle part, and the maximum value is late diastolic period noise when being positioned at the rear half part; when the variation trend of the pulse peak value approaches to a straight line, the pulse peak value is full-diastole noise.

In the presence of diastolic murmurs, for each heart sound map of the auscultation area, diastolic murmurs are identified in all cardiac cycles of the current heart sound map to determine whether S3 or S4.

Further, in the phonocardiogram of one auscultation area, if the current diastole noise figure is an independent pulse figure after S2, sequentially acquiring a time interval Deltat 1 between the diastole noise and A2 of the current cardiac cycle in each cardiac cycle in the phonocardiogram of the current auscultation area; if Δt1 is close and the diastolic noise patterns are similar, and Δt1 corresponds to the time when the third heart sound S3 appears, the diastolic noise is regarded as S3.

Further, in the phonocardiogram of one auscultation area, if the current diastole noise figure is an independent pulse figure before the next S1, sequentially acquiring a time interval delta t2 between the diastole noise and M1 of the next cardiac cycle in each cardiac cycle in the phonocardiogram of the current auscultation area; if Δt2 is close and the diastolic noise patterns are similar, and Δt2 corresponds to the time when the third heart sound S4 appears, the diastolic noise is regarded as S4.

Identifying heart murmur primary region and direction of delivery

After M1, T1, A2 and P2 are positioned on a time axis, whether noise exists or not and the strong and weak orders of the noise amplitude are identified on the phonocardiogram of different auscultation areas in the same cardiac cycle so as to identify the position and the transmission direction of occurrence of heart abnormality.

A method of identifying heart murmur generation and transmission directions, comprising the steps of:

1) Acquiring a cardiac cycle as a current cardiac cycle;

2) Sequentially acquiring a D1 graph of each heart sound graph between T1 and A2 of the current cardiac cycle;

3) Aiming at the D1 graph, if a pulse signal with obvious amplitude is provided for the D1 graph of the heart sound graph of one auscultation area, outputting that the auscultation area has systolic noise; if the D1 graphs of the heart sound graphs of the auscultation areas have pulse signals with obvious amplitude values, the amplitude values of the D1 graphs are obtained, the auscultation areas are arranged from large to small according to the amplitude values of the D1 graphs, the auscultation areas are ordered to be the transmission direction of the noise, and the valve corresponding to the auscultation area with the largest amplitude value is probably the original position of the lesion.

Further, sequentially acquiring a D2 graph of each phonocardiogram from P2 of the current cardiac cycle to M1 of the next cardiac cycle; aiming at the D2 graph, if a pulse signal with obvious amplitude is provided for the D2 graph of the heart sound graph of one auscultation area, outputting the auscultation area with diastolic murmurs; if the D2 graphs of the heart sound graphs of the auscultation areas have pulse signals with obvious amplitude values, the amplitude values of the D2 graphs are obtained, the auscultation areas are arranged from large to small according to the amplitude values of the D2 graphs, the auscultation areas are ordered to be the transmission direction of the noise, and the valve corresponding to the auscultation area with the largest amplitude value is probably the original position of the lesion. Having a significant amplitude means that the amplitude of each sample point does not vibrate only within the range allowed by the error above and below the horizontal line.

When only one heart sound image of the auscultation area has diastolic murmurs, for each diastolic murmur image, if the current diastolic murmur image is an independent pulse image after S2, sequentially acquiring a time interval delta t1 between the diastolic murmurs and A2 of the current heart cycle in each heart sound image of the current auscultation area; if Deltat 1 is similar, and the diastolic noise patterns are similar, and Deltat 1 accords with the occurrence time of the third heart sound S3, the diastolic noise is regarded as S3; when the diastolic murmur determination is S3, the output has the third heart sound, and the transmission direction determination is not made. The independent pulse pattern means that the amplitude of the sampling point between the S2 and the current diastolic murmur pattern vibrates only within the allowable range of the horizontal line up-down error.

When only one heart sound image of the auscultation area has diastolic murmurs, for each diastolic murmur image, if the current diastolic murmur image is an independent pulse image before the next S1, sequentially acquiring a time interval delta t2 between the diastolic murmurs and M1 of the next heart cycle in each heart cycle of the heart sound image of the current auscultation area; if Deltat 2 is similar, and the diastolic noise patterns are similar, and Deltat 2 accords with the occurrence time of the third heart sound S4, the diastolic noise is regarded as S4; when the diastolic murmur determination is S4, the output has the fourth heart sound, and the transmission direction determination is not made. The independent pulse pattern means that the amplitude of the sampling point between the S2 and the current diastolic murmur pattern vibrates only within the allowable range of the horizontal line up-down error.

The invention has the advantages that:

1. and the electrocardiogram and the phonocardiogram are synchronously acquired, the heart cycle of the electrocardiogram is matched with the heart cycle of the phonocardiogram, the primary diagnosis of the heart condition is realized by utilizing the corresponding relation of the electrocardiograph and the phonocardiogram, the dependence on professionals is reduced, the automatic identification of heart abnormality and the alarm are realized, and the heart condition monitoring system is suitable for household monitoring of the heart condition.

2. And (3) searching an electrocardiograph by using R wave positioning of the electrocardiograph, and searching an electrocardiograph S2 by using T wave of the electrocardiograph to correspond to heart sounds, so as to identify abnormal heart conditions.

3. In the same cardiac cycle, S1 and S2 of each auscultation area are continuously compared to identify whether the heart sound sensor is correctly positioned, so that automatic error correction of the position of the heart sound sensor is realized.

4. Identifying and positioning M1, T1, A2 and P2 according to a heart sound auscultation rule, and identifying whether S1 is split normally or not according to the time interval of M1 and T1; a2 The time interval of P2 identifies whether S2 splits normally; the time interval of T1 and A2 identifies whether systolic murmurs exist; the time interval of P2, M1 identifies the presence or absence of diastolic murmurs.

5. In the heart sound chart of the same auscultation area, the change trend of S1 and S2 is identified by continuously comparing the S1 amplitude and the S2 amplitude in all cardiac cycles, so that early detection of heart failure is facilitated.

6. If heart murmurs exist, the original position and the transmission direction of murmurs are initially found by continuously comparing murmurs waveforms of auscultation areas in the same cardiac cycle.

Detailed Description

The principle of the invention is as follows: the electrical signals emitted by the sinus node are transmitted to the right atrium and the left atrium, the atrial excitation is represented as P waves of an electrocardiogram, the excitation of the right atrium is transmitted to the atrioventricular node, the atrioventricular node transmits the excitation to the left ventricle and the right ventricle, the ventricular excitation is represented as R waves of the electrocardiogram, and the ventricular repolarization is represented as T waves of the electrocardiogram. Ventricular repolarization waits for the next excitation of the sinoatrial node. Within the same cardiac cycle, the electrocardiogram should have P, R and T waves.

The generation of S1 is related to the closure of the mitral valve (T1) and the tricuspid valve (M1), and the generation of S2 is caused by the closure of the aortic valve (A2) and the pulmonary valve (P2). Within one cardiac cycle, the phonocardiogram should have S1 and S2. When the cardiac cycle of the electrocardiogram does not correspond to the cardiac cycle of the phonocardiogram, an abnormality in the heart state is likely to occur.

According to the flow direction of heart blood, there is tricuspid valve between right atrium and right ventricle, there is mitral valve between left atrium and left ventricle, there is pulmonary valve between right ventricle and pulmonary artery, there is aortic valve between left ventricle and aorta. The right atrium excites, the tricuspid valve opens, blood flow enters the right ventricle, the tricuspid valve closes, the right ventricle excites, and blood flow enters the pulmonary artery. The blood after pulmonary circulation enters the left atrium, the mitral valve opens the blood into the left ventricle, the mitral valve closes, the left ventricle excites, and blood flow enters the aorta. Ventricular excitation is necessarily accompanied by the closure of the tricuspid valve and mitral valve; ventricular repolarization is also necessarily accompanied by closure of the pulmonary and aortic valves. Therefore, the R wave of the electrocardiograph has a medical correspondence with the S1 of the heart sound, and the T wave of the electrocardiograph has a medical correspondence with the S2 of the heart sound.

The heart sound auscultation area at least comprises the apex (M area), the left side of the bottom of the heart (P area), the right side of the bottom of the heart (A area) and the left sternum edge (T area). The electrocardiographic features of an electrocardiogram include at least R-waves and T-waves.

In heart sound auscultation, the M1 component in S1 can be heard at all auscultation sites, but is most clearly heard in the apex region M, so the M1 amplitude of the M region should be the maximum value in all auscultation regions. And M1 is higher than T1 in intensity, so that the amplitude of S1 in the M region is actually the amplitude of M1, and the moment when the amplitude occurs is the moment when M1 occurs.

T1 follows M1, but little energy is generated to T1, which can only be heard in the left sternal edge T region. Thus, in S1 of the T-zone phonocardiogram, M1 and T1 should appear. And pulses of similar amplitude to M1 should not occur at the T1 location of the other auscultatory region.

The A2 component of S2 is audible at all auscultatory sites, but the best auscultatory site is the area A on the right side of the bottom of the heart, and the intensity of A2 is greater than that of P2, so that the S2 amplitude of the area A is actually the amplitude of A2 and is the greatest compared to other auscultatory areas.

P2 is the second component of S2, and P2 is generally heard only on the left side of the bottom of the heart after A2. Thus, in S2 of the P-zone phonocardiogram, A2 and P2 "should appear. And no pulses of similar amplitude to A2 should occur at the P2 position of the auscultation area.

A method for analyzing multi-path heart sounds, comprising the steps of:

step 3: searching heart sound characteristics of each path of heart sound chart according to the corresponding heart sound characteristics, wherein the heart sound characteristics comprise S1 and S1;

3.2 Searching the peak with the maximum amplitude, and judging the time interval T between the peak and the current R wave _R1 Whether or not it is smaller than the time interval T between the peak and the current electrocardiographic end time _R2 If yes, taking the peak with the largest amplitude as a T wave, and marking the moment of the T wave.

As a preferable scheme, the electrocardio characteristic also comprises P waves, and the P waves are determined on the basis of determining T waves.

The P wave determination method comprises the following steps: intercepting an electrocardio graph with the length of T from the current R wave backwards, intercepting a graph after the T wave as a current analysis graph, sampling the current analysis graph to acquire the amplitude of each sampling point, and identifying all wave peaks in the current electrocardio graph, wherein the wave peaks refer to the sampling points with the amplitude larger than that of the adjacent sampling points before and after the current electrocardio graph;

The scheme for obtaining the intensity of S1 is as follows: the following operations are performed in each cardiac cycle: acquiring R waves and T waves of an electrocardiogram of a current cardiac cycle, respectively taking graphs of RT intervals as current heart sound graphs for each heart sound graph, sampling the current heart sound graphs to obtain the amplitude of each sampling point, and finding out the sampling point with the maximum amplitude; acquiring an interval T between a maximum amplitude sampling point and R waves _R And the interval T between the maximum amplitude sampling point and the T wave _T Determine whether T _R <T _T If yes, taking the sampling point with the maximum amplitude as S1 of the current cardiac cycle of the current phonocardiogram, and taking the maximum amplitude as the intensity of S1; if not, the sampling frequency is increased, and the step is repeated; by M _S1 Representing the S1 intensity of the M region, expressed as P _S1 S1 intensity representing P region, A _S1 Represents the S1 intensity, T of region A _S1 The S1 intensity of the T region is indicated.

When four heart sound sensors are positioned at the correct auscultation positions, whether the heart sound image corresponds to the auscultation area or not is identified

As a preferred scheme, M is found out _S1 ，P _S1 ，A _S1 ，T _S1 MAX of (2) _S1 Determine whether M _S1 ＝MAX _S1 If yes, outputting an M area to be in place; if not, record MAX _S2 The original auscultation area corresponding to the heart sound image is located, and then the heart sound image with the maximum value MAX is marked as an M area; the original M area is marked as the auscultation area to be determined.

As a preferred scheme, M is found out _S2 ，P _S2 ，A _S2 ，T _S2 MAX of (2) _S2 Determine whether A _S2 ＝MAX _S1 If yes, outputting the zone A to be in place; if not, record MAX _S2 The auscultation area corresponding to the heart sound image is marked as an A area; the original A area is marked as the auscultation area to be determined.

The multi-path heart sound auscultation heart sound sensor position identification method comprises the following steps:

1. judging whether the M area phonocardiogram corresponds to the M area auscultation area or not:

r waves in electrocardiographs are acquired, S1 corresponding to the current R wave in each electrocardiograph is acquired respectively, and the amplitude of the S1 is acquired as M _S1 Representing the S1 amplitude of the M region, in terms of P _S1 S1 amplitude representing P region, A _S1 S1 amplitude, T representing zone A _S1 S1 amplitude representing T region; judging whether M _S1 Maximum, if yes, consider that M district heart sound sensor is in place, and record M _S1 Time of occurrence T _MS1 If not, the M area is abnormal.

2. Judging whether the P area phonocardiogram corresponds to the P area auscultation area and whether the A area phonocardiogram corresponds to the A area auscultation area:

1) Acquiring T waves in the electrocardiogram, respectively acquiring S2 corresponding to the current T waves in each heart sound chart, and acquiring the amplitude of the S2 to M _S2 Representing the S2 amplitude of the M region, in terms of P _S2 S2 amplitude, A, representing the P region _S2 S2 amplitude, T, representing zone A _S2 S2 amplitude representing T region; judging whether A _S2 Maximum, if yes, considerThe heart sound sensor in zone A is in place and record A _S2 Time of occurrence T _AS2 The method comprises the steps of carrying out a first treatment on the surface of the If not, the position of the area A is abnormal;

2) Judging whether or not P _S2 The second largest, if yes, consider the P area heart sound sensor to be in place and record P _S2 Time of occurrence T _PS2 The method comprises the steps of carrying out a first treatment on the surface of the If not, the P area is abnormal.

The judgment of the M area and the judgment of the A area and the P area are carried out according to the appointed sequence or synchronously.

3. Judging whether the T-zone phonocardiogram corresponds to a T-zone auscultation zone or not:

1) Acquiring R waves of an electrocardiogram, and respectively acquiring S1 corresponding to the current R waves in each heart sound chart;

2) By T _MS1 Marking S1, and acquiring the sum T in the heart sound image of the T region _MS1 Corresponding current S1, judging T in the current S1 _MS1 Whether the time has obvious wave peaks or not is judged, if yes, the heart sound sensor in the T area is considered to be in place, and the time T when the obvious wave peaks appear is recorded _TS1 If not, the T area is abnormal.

The A2 component in S2 can be heard in all auscultation sites, but the best auscultation site is the area A on the right side of the bottom of the heart, and the intensity of A2 is larger than that of P2,thus, the S2 amplitude of zone A is actually the amplitude of A2, and A _S2 Maximum, A compared with other auscultation areas _S2 The appearance time is the appearance time of A2. If the phonocardiogram of the A region accords with A _S2 Compared with other auscultation areas, the auscultation area A is the largest, and the heart sound chart of the area A corresponds to the auscultation area A correctly. If not, the heart sound image of the area A is not corresponding to the auscultation area of the area A.

As a preferred scheme: the heart sound characteristics are obtained according to the positioning of the electrocardio characteristics, and the method for determining the heart sound characteristics M1, T1, A2 and P2 comprises the following steps:

A. r waves are acquired for each cardiac cycle in an electrocardiogram respectively, S1 corresponding to the current R waves on an M-region heart sound chart is acquired, and the occurrence time T of the maximum value of the S1 is acquired _S1 ，T _S1 As the corresponding time of M1, T is _S1 Marking M1 of all phonocardiograms;

B. s2 corresponding to the current T wave on the heart sound chart of the area A is obtained, and the maximum value occurrence time T of the S2 is obtained _S2 ，T _S2 As the corresponding time of A2, T is _S2 A2, marking all phonocardiograms;

C. acquiring T on heart sound chart of T region _S1 Labeled S1, T is obtained _S1 The first distinct peak that appears later, the distinct peak being referred to as the heel T _S1 The amplitude values at the moments are similar and can be obtained according to statistics of T1 amplitude data, and T is adopted _S1 After which the first distinct peak occurs at time T _T1 As the corresponding time of T1, T is taken as _T1 Marking T1 of all phonocardiograms;

D. acquiring T on P region phonocardiogram _S2 Labeled S2, T is obtained _S2 The first to appear thereafterDistinct peak, which refers to the heel T _S2 The amplitude values of the moments are similar, and can be obtained according to P2 amplitude data statistics by T _S2 Then the first apparent peak occurs at time T _P2 As the corresponding time of P2, T is _P2 P2 of all phonocardiograms is marked.

In some embodiments, the method of acquiring S1 from R-waves is: obtaining the moment T when the R wave crest value appears _R At T _R The waveform on the phonocardiogram is acquired in a designated time interval and is recorded as S1; the specified time interval is within the RT time interval of the electrocardiogram and the first peak of S1 occurs before the end of the electrocardiographic S wave.

In some embodiments, the method of acquiring S2 from the T wave is: obtaining the moment T of occurrence of the wave crest of the T wave _T At T _T Then, acquiring waveforms on the phonocardiogram in a given time interval, and recording the waveforms as S2; the given time interval follows the T wave of the electrocardiogram, precedes the P wave of the next cardiac cycle, and the first peak of S2 occurs before the end of the T wave.

In some embodiments, T is acquired for each heart cycle for the phonocardiogram of each auscultatory region _T1 The amplitude of the moment, determine whether T of the T area _T1 The amplitude of the moment is maximum, if so, the T is considered _T1 If the mark is correct, repeating the step 3 until T _T1 The mark is correct.

In some embodiments, T is acquired for each heart cycle for the phonocardiogram of each auscultatory region _P2 The amplitude of the moment, determine whether T of the P area _P2 The amplitude of the moment is maximum, if so, the T is considered _P2 If the mark is correct, repeating the step 4 until T _P2 The mark is correct.

Scheme for identifying heart sound enhancement

The scheme for identifying S1 enhancement or attenuation is as follows: 1) Acquiring M-zone phonocardiogram with M zone T in each cardiac cycle _S1 If the amplitude of the moment is compared with the normal amplitude of M1, the M area T _S1 Amplitude of time of day>M1 is normal in amplitude, and the current cardiac cycle S1 is considered to be enhanced; if M region T _S1 Amplitude of time of day<M1 is normal in amplitude, the current cardiac cycle S1 is considered to be weakened; if M region T _S1 The amplitude of the moment is in a normal range, and the current cardiac cycle S1 is considered to be normal;

2) Continuously identifying the S1 amplitude of each cardiac cycle of the M region, and outputting S1 enhancement if the S1 of all cardiac cycles is enhanced; outputting S1 alternations of enhancement and attenuation if S1 enhancement and S1 attenuation alternates; if S1 of all cardiac cycles is weakened, then the output S1 is weakened; if the number of the cycles of S1 enhancement and/or S1 weakening is smaller than a preset value, S1 is considered to be normal;

the judgment of S1 splitting and S1 enhancement or attenuation is carried out according to a given sequence or synchronously.

the scheme for identifying the enhancement or attenuation of S2 is as follows: 1) Acquiring a heart sound image of the area A, and taking the area A as the area T in each cardiac cycle _S1 If the amplitude of the moment is compared with the normal amplitude of A2, if the area A T _S1 Amplitude of time of day>A2, regarding that the current cardiac cycle S2 is enhanced if the amplitude of the A2 is normal; if zone A T _S2 Amplitude of time of day<A2, regarding that the current cardiac cycle S2 is weakened if the amplitude of the A2 is normal; if zone A T _S2 The amplitude of the moment is in a normal range, and the current cardiac cycle S2 is considered to be normal;

2) Continuously identifying the S2 amplitude of each cardiac cycle of the A region, and outputting S2 enhancement if the S2 of all cardiac cycles is enhanced; outputting S2 alternations of enhancement and attenuation if S2 enhancement and S2 attenuation alternates; if S2 of all cardiac cycles is weakened, then the output S2 is weakened; and if the number of the cycles of S2 enhancement and/or S2 weakening is smaller than a preset value, S2 is considered to be normal.

Scheme for recognizing heart murmurs

The method for identifying heart murmurs is as follows:

Identifying heart murmur primary region and direction of delivery

1) Acquiring a cardiac cycle as a current cardiac cycle;

Further, sequentially acquiring a D2 graph of each phonocardiogram from P2 of the current cardiac cycle to M1 of the next cardiac cycle; aiming at the D2 graph, if a pulse signal with obvious amplitude is provided for the D2 graph of the heart sound graph of one auscultation area, outputting the auscultation area with diastolic murmurs; if the D2 graphs of the heart sound graphs of the auscultation areas have pulse signals with obvious amplitude values, the amplitude values of the D2 graphs are obtained, the auscultation areas are arranged from large to small according to the amplitude values of the D2 graphs, the auscultation areas are ordered to be the transmission direction of the noise, and the valve corresponding to the auscultation area with the largest amplitude value is probably the original position of the lesion.

The invention has the advantages that:

When the auscultation area of the heart sounds also contains additional auscultation areas, such as the second auscultation area Erb of the aorta, the location of the additional auscultation areas can also be correspondingly determined if they are correctly located after the areas a, P, M and T are identified as being located.

The terms and expressions which have been employed herein are used as terms of description and not of limitation, and there is no intention in the use of such terms and expressions of excluding any equivalents of the features shown and described or portions thereof, and it is recognized that various modifications are possible within the scope of the invention. It is therefore to be understood that while the present invention has been specifically disclosed by various embodiments and optional features, modification and variation of the concepts herein described may be resorted to by those skilled in the art, and that such modifications and variations are considered to be within the scope of this invention as defined by the appended claims.

The contents of the articles, patents, patent applications, and all other documents and electronically available information described or documented herein are incorporated by reference in their entirety to the same extent as if each individual publication was specifically and individually indicated to be incorporated by reference. Applicants reserve the right to incorporate any and all materials and information from any such articles, patents, patent applications, or other documents.

Claims

1. The heart murmur type identification method based on multipath heart sounds comprises the following steps:

step 3: searching heart sound characteristics of each path of heart sound chart according to the corresponding of each heart sound characteristic, wherein the heart sound S1 and the S1 comprise M1 and T1;

step 3.1: r waves are acquired for each cardiac cycle in an electrocardiogram respectively, S1 corresponding to the current R waves on an M-region heart sound chart is acquired, and the occurrence time T of the maximum value of the S1 is acquired _S1 ，T _S1 As the corresponding time of M1, T is _S1 Marking M1 of all phonocardiograms;

step 3.2: acquiring T on heart sound chart of T region _S1 Labeled S1, T is obtained _S1 The first distinct peak that appears later, the distinct peak being referred to as the heel T _S1 The amplitude values at the moments are similar and can be obtained according to statistics of T1 amplitude data, and T is adopted _S1 After which the first distinct peak occurs at time T _T1 As the corresponding time of T1, T is taken as _T1 Marking T1 of all phonocardiograms;

step 3.3: s2 corresponding to the current T wave on the heart sound chart of the area A is obtained, and the maximum value occurrence time T of the S2 is obtained _S2 ，T _S2 As the corresponding time of A2, T is _S2 A2, marking all phonocardiograms;

step 3.4: acquiring T on P region phonocardiogram _S2 Labeled S2, T is obtained _S2 The first distinct peak that appears later, the distinct peak being referred to as the heel T _S2 The amplitude values of the moments are similar, and can be obtained according to P2 amplitude data statistics by T _S2 Then the first apparent peak occurs at time T _P2 As the corresponding time of P2, T is _P2 Marking P2 of all phonocardiograms;

step 4: systolic murmurs are identified between T1-A2, diastolic murmurs are identified between P2 and the next M1:

step 4.1, respectively obtaining a D1 graph between T1 and A2 and a D2 graph between P2 and the next M1 for each cardiac cycle of the heart sound chart of each auscultation area,

Step 4.2, judging whether the up-down fluctuation of the D1 is in a normal range, if so, judging that the systolic period of the current cardiac cycle has no noise, if not, judging that the current cardiac cycle has systolic period noise, and recording the auscultation area, the cardiac cycle and the systolic period noise graph;

step 4.3, judging whether the up-down fluctuation of the D2 is in a normal range, if so, judging that the diastole of the current cardiac cycle is free of noise, otherwise, judging that the diastole of the current cardiac cycle is noise, and recording the auscultation area, the cardiac cycle and the diastole noise graph;

and when the diastolic murmur exists, identifying the diastolic murmur in all cardiac cycles of the current heart sound map for the heart sound map of each auscultation area so as to judge whether the diastolic murmur is S3.

2. The method for identifying heart murmur types based on multiple heart sounds of claim 1, wherein: for each systolic period noise figure, identifying the variation trend and the maximum value of a pulse peak value in the current systolic period noise figure, judging that the maximum value is positioned at the position of the current systolic period noise figure when the pulse peak value is weakened or strengthened from S1 to S2, wherein the maximum value is early-stage systolic noise when the maximum value is positioned at the front half part, the maximum value is middle-stage systolic noise when the maximum value is positioned at the middle part, and the maximum value is late-stage systolic noise when the maximum value is positioned at the rear half part; when the variation trend of the pulse peak value approaches to a straight line, the pulse peak value is a full-systolic noise.

3. The method for identifying heart murmur types based on multiple heart sounds of claim 1, wherein: in a heart sound graph of an auscultation area, for each diastolic period noise graph, if the current diastolic period noise graph is an independent pulse graph after S2, sequentially acquiring a time interval delta t1 between the diastolic period noise and A2 of the current heart cycle in each heart cycle of the heart sound graph of the current auscultation area; if Δt1 is close and the diastolic noise patterns are similar, and Δt1 corresponds to the time when the third heart sound S3 appears, the diastolic noise is regarded as S3.

4. The method for identifying heart murmur types based on multiple heart sounds of claim 1, wherein: the method for acquiring S1 according to the R wave comprises the following steps: obtaining the moment T when the R wave crest value appears _R At T _R The waveform on the phonocardiogram is acquired in a designated time interval and is recorded as S1; the specified time interval is within the RT time interval of the electrocardiogram, and the first peak of S1 appears before the end of the electrocardiographic S wave;

the method for acquiring S2 according to the T wave comprises the following steps: obtaining the moment T of occurrence of the wave crest of the T wave _T At T _T Then, acquiring waveforms on the phonocardiogram in a given time interval, and recording the waveforms as S2; the given time interval follows the T wave of the electrocardiogram, precedes the P wave of the next cardiac cycle, and the first peak of S2 occurs before the end of the T wave.