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Digital Acoustic Analysis of Precordial Innocent Versus Ventricular Septal Defect Murmurs in Children

1997; Elsevier BV; Volume: 79; Issue: 11 Linguagem: Inglês

10.1016/s0002-9149(97)00194-x

1879-1913

Douglas A. Balster, David P. Chan, Daniel G. Rowland, Hugh D. Allen,

Machine Fault Diagnosis Techniques

With recent advances in technology, digital acoustic cardiography (DAC) has evolved allowing objective and visual representation of heart sounds.[ 1 Wood J Barry D Quantification of first heart sound frequency dynamics across the human chest wall. Med Biol Eng Comput. 1994; 32: S71-S78 Crossref PubMed Scopus (16) Google Scholar , 2 Wood J Buda A Barry D Time-frequency transforms: a new approach to first heart sound frequency dynamics. IEEE Trans Biomed Eng. 1992; 39: 730-740 Crossref PubMed Scopus (82) Google Scholar , 3 Bulgrin J Rubal B Thompson C Moody J Comparison of short-time Fourier, wavelet and time-domain analyses of intracardiac sounds. Biomed Sci Instrum. 1993; 29: 465-472 PubMed Google Scholar ]Advances in digital signal processing allow this new technology to detect and analyze the individual heart sound components of the cardiac cycle in terms of timing, frequency, and intensity. Previous reports have suggested that this technique would allow unique interpretation with high sensitivity and specificity.[ 4 O'Rourke R Differentiation of cardiac murmurs by dynamic auscultation. Curr Probl Cardiol. 1988; 13: 669-721 Abstract Full Text PDF PubMed Google Scholar , 5 Donnerstein R Continuous spectral analysis of heart murmurs for evaluating stenotic cardiac lesions. Am J Cardiol. 1989; 64: 625-630 Abstract Full Text PDF PubMed Scopus (22) Google Scholar , 6 Donnerstein R Thomsen V Hemodynamic and anatomic factors affecting the frequency content of Still's innocent murmur. Am J Cardiol. 1994; 74: 508-510 Abstract Full Text PDF PubMed Scopus (16) Google Scholar ]From earlier phonocardiography studies[ 6 Donnerstein R Thomsen V Hemodynamic and anatomic factors affecting the frequency content of Still's innocent murmur. Am J Cardiol. 1994; 74: 508-510 Abstract Full Text PDF PubMed Scopus (16) Google Scholar , 7 Stein P Sabbah H Aortic Origin of innocent murmurs. Am J Cardiol. 1977; 39: 665-671 Abstract Full Text PDF PubMed Scopus (34) Google Scholar , 8 Stein P Sabbah H Lakier J Origin and clinical relevance of musical murmurs. Int J Cardiol. 1983; 4: 103-112 Abstract Full Text PDF PubMed Scopus (14) Google Scholar , 9 McCrindle BW Shaffer KM Kan JS Zahka KG Rowe SA Kidd L Cardinal clinical signs in the differentiation of heart murmurs in children [see comments]. Arch Pediatr Adolesc Med. 1996; 150: 169-174 Crossref PubMed Scopus (93) Google Scholar ]and clinical observations, we hypothesized that pathologic precordial murmurs possess higher frequency and higher intensity auscultatory sounds than innocent murmurs. Therefore, this study examines whether digital analysis of individual cardiac sound components could differentiate between innocent and pathologic murmurs.