RU127605U1 - PROTECTED TELEMEDICINE SYSTEM OF REMOTE IDENTIFICATION OF EARLY STAGES OF HEART DISEASES - Google Patents

Abstract

A secure telemedicine system for remote detection of the early stages of heart disease, including a device for acquiring acoustic heart signals and a device for measuring blood pressure and heart rate, characterized in that the device for acquiring acoustic heart signals and a device for measuring blood pressure and heart rate are connected to a personal computer that is connected to a data encryption module using an electronic digital signature, a data encryption module is connected to the person transmission module patient data via the Internet to a cardiocenter server, which includes a data decryption module connected to a module for displaying blood pressure and heart rate and to a module for acquiring an acoustocardiogram of the heart using multilevel wavelet analysis technology.

Description

The utility model relates to cardiology and telemedicine, and more specifically to a remote diagnostic system for the early stages of heart disease.

Current methods for diagnosing heart disease include auscultation of the heart, based on the use of a phonendoscope, electrocardiograph or phonograph.

The prior art device for remote monitoring of heart activity [RU 2458625 C1, Open Joint Stock Company "Vanguard" (RU), 08/20/2012, IPC - А61В 5/00 (2006.01), А61В 5/04 (2006.01)], consisting from equipment placed on the observed person, and equipment placed at the control point. Equipment placed on the observed person includes: electrodes, pre-amplifier, high-frequency generator, amplitude modulator, modulating code generator, phase manipulator, power amplifier and transmitting antenna. The equipment located at the control point consists of: a receiving antenna, a tuning block, microprocessors, alarm generating blocks, magnetic recorders, local oscillators, mixers, intermediate frequency amplifiers, amplitude detectors, keys, detectors, delay lines, synchronous detectors, amplitude limiters, phase detectors, correlator, third threshold block and logical element OR.

The disadvantage of this device is the inability to measure minor noise and small signals of the heart, i.e. low resolution.

A diagnostic device is known from the prior art [EP 1051945 A2, Remote Diagnostic Technologies Limited London W8 6AB (GB), 11/15/2000, IPC - A61B 5/00] containing medical sensors (pulse oximeter, capnometer, blood pressure monitor, etc. ) connected to a processor that includes PCs and modems. The device operator freely controls a headset containing a microphone and headphones, and monitors the display. Medical signals from sensors, images received from the camera, and sound signals obtained using a microphone are processed by the processor and transmitted remotely for use by a practitioner who has the appropriate processor and monitor to diagnose the patient's condition. The diagnostic device and the data center stores corresponding identical libraries of contextually accurate auxiliary screens, including, for example, graphic files illustrating the operation of the device. Images received from the camera are stored in the device’s memory and in the processing center. The disadvantages of this device are the complexity and low resolution.

The prior art complex for express diagnostics of the heart [RU 55266 U1, Limited Liability Company “Medical Computer Systems” (RU), 08/10/2006, IPC - А61В 5/0402 (2006.01)], consisting of an electrode system, an amplifier unit an electrocardiographic signal converter, an electrocardiographic signal processing unit based on a microprocessor, an electrocardiographic signal visualization unit, an information display means equipped with a data storage unit, an electrocardiographic analysis unit signals, a unit for visualizing the portrait of the heart, a unit for presenting an integral assessment, and a unit for presenting textual conclusions. This complex is designed to measure electrical microalternations of the ECG signal, which are effective predictors of pathological and life-threatening conditions.

The disadvantages of this complex are:

1) Low resolution measurement due to the use of electrocardiography.

2) The device has a high noise immunity, however, the main cause of hypersensitivity of the device may be artifacts of the ECG signal caused by muscle tremor.

Thus, the above devices in connection with the use of the ECG method, which has insignificant informativeness of electric potentials, as a medium for transmitting complex, multi-level non-stationary information about the work of the cardiovascular system of a person, do not allow to detect the early stages of heart diseases, the signs of which are the appearance of insignificant noise and acoustic signals small levels.

In general, the disadvantages of tools that use the removal and processing of electrical potentials of the ECG heart work include the following:

- do not reflect the presence of heart murmur;

- do not directly diagnose heart defects and tumors;

- does not reflect hemodynamics;

- the short duration of the recording (which sometimes has to be supplemented by the monitoring method according to Holter - the method of a long, 1-2 days recording of ECG indicators);

- a test taken at rest may not reveal an existing disease (supplemented by an ECG with a load);

- high price.

The inventive protected telemedicine system is a complex of software and hardware that can effectively detect the early stages of cardiovascular disease.

The utility model is the development of the method of phonocardiography (FCG) based on new, high-precision technologies for processing heart sounds and complements the ECG diagnostic method for cardiac diseases.

The technical result, which the utility model aims to achieve, is to increase the resolution when measuring sound signals (tones and noises) of the heart.

The technical result is achieved due to the fact that the protected telemedicine system for remote detection of the early stages of heart disease includes a device for acquiring acoustic heart signals and a device for measuring blood pressure and heart rate, a device for acquiring acoustic heart signals and a device for measuring blood pressure and heart rate a computer that is connected to a data encryption module using an electronic digital signature, a data encryption module with The uniform module of personal patient data transmission through the Internet to a server Cardiology, which includes decryption data module connected to the module indicating blood pressure and pulse rate and with a module receiving akustokardiogrammy heart using a layered wavelet analysis technology.

The figure 1 shows a structural diagram of a system for detecting the early stages of heart disease.

The figure 2 presents the appearance of the device for picking up acoustic signals of the heart.

The figure 3 presents the acoustic signals of the heart, obtained using a device for the collection of acoustic signals of the heart.

Figure 4 shows acoustocardiograms ("sound portraits") of a healthy heart, and figure 5 shows a heart affected by mitral valve stenosis.

The protected telemedicine system for remote detection of the early stages of heart disease (Fig. 1) includes a device for acquiring acoustic signals of the heart (1), which can consist of a small-sized condenser microphone with a vacuum suction cup for mounting in the projection area of the apex of the heart (Fig. 2) and a module analog-to-digital conversion for transmitting digitized acoustic heart signals to the memory of a personal computer (3). Information on the measured blood pressure and heart rate, obtained using a device for measuring blood pressure and heart rate (2), is also recorded in the PC memory. The personal computer processes the incoming information and generates a message that is encrypted in the data encryption module (4) and then goes to the patient personal data transmission module (5). The patient’s personal data transfer module plays the role of an interface between the Internet channel and the encryption module, this module converts the encrypted message into the type of signal that corresponds to the type of Internet channel (wired, wireless). The encrypted message is sent to the cardiocenter server, in which it is decrypted in the data decryption module (6). The decrypted data goes to the inputs of 2 modules:

1) a module for indicating blood pressure and heart rate (7), which extracts from the data and displays information about the measured blood pressure of the patient and heart rate;

2) a module for obtaining an acoustocardiogram of the heart using the technology of multi-level wavelet analysis (8), which, using high-precision technologies for processing heart sounds, builds the so-called "sound portraits" of the heart (Figures 4 and 5).

An expert doctor evaluates the patient’s condition taking into account the obtained data of the acoustocardiogram, blood pressure and heart rate, and also prepares a textual report of express diagnostics for the patient and entering the conclusion materials into the database.

As a device for measuring blood pressure and heart rate, a tonometer (Digital Automatic Blood Pressure Monitor), the OMRON MIT Elit Plus model can be used, and a microphone: Logitech USB Desktop Microphone.

The figure 4 presents the acoustocardiogram of normal heart function: time-frequency images of 1 and 2 tones - without distortion; no noise in the systolic and diastolic region.

In figure 5 - “sound portraits” of the heart affected by mitral valve stenosis: time-frequency images of 1 and 2 tones are distorted and have the appearance characteristic of this disease.

A description of methods for obtaining high-precision frequency-time characteristics of heart sounds and sounds is presented in the journal Functional Diagnostics, No. 2, 2012 (Gorshkov Yu.G. “New Digital Technologies for Processing Heart Sounds”), as well as on the site.

An example of early diagnosis of heart disease using acoustocardiograms is presented in Appendix 1.

Bibliography

1. Daubechies. Ten Lectures on Wavelets. // Number 61 in CBMS-NSF Series in Applied Mathematics. SIAM Publications, Philadelphia, 1992.

2. Astafieva H.M. Wavelet Analysis: Fundamentals of the Theory and Application Examples // Uspekhi Fizicheskikh Nauk. November 1996, Volume 166, No. 11. - S.1145-1170.

3. Vorobiev V.I., Gribunin V.G. Theory and practice of wavelet transforms. 1999. S.-Pb .: VUS. - S.202.

4. Dyakonov V.I. Wavelets: from theory to practice. M .: Solon-R, 2002. - P.440.

5. Gorshkov Yu.G. Biometric sound processing systems using multilevel wavelet analysis technology // Biomechanics-2011. Workshop, February 2-4, 2011, St. Petersburg.

6. Gorshkov Yu.G. New digital technologies for processing heart sounds. Functional diagnostics, Moscow. No. 2, 2012.

Annex 1.

AN EXAMPLE OF EARLY DIAGNOSIS OF HEART DISEASE

The processing of the phonogram recording, referred to as “normal” work of the heart, was performed (the audio recording is presented on the site, mp3 format). Conclusion: “normal” work of the heart ”- made by a cardiologist based on the results of auscultation of the patient’s heart and ECG data.

At the same time, analysis of the acoustocardiograms obtained showed that throughout the recording (12 seconds) deviations from normal heart function were revealed: repetition of the time-frequency structure of the “odd” and “even” pairs of the 1st and 2nd heart sounds (Fig. 6, acoustocardiogram No. 6).

From the analysis of acoustocardiogram No. 6, it follows that for 2 and 4 “pairs” of heart sounds, slight “foci” of incipient systolic and diastolic murmurs were outlined. This symptom characterizing the early stage of the disease of the valvular apparatus of the heart is steadily manifested throughout the recording duration.

The figure 7 presents the acoustocardiogram with increased time-frequency resolution (acoustocardiogram No. 7).

From the analysis of the acoustocardiogram No. 7 it follows that for the I “pair” of heart sounds:

- mesosystolic noise in the range of 0.59 s-0.68 s; noise frequency varies from 90 Hz to 50 Hz;

- mesodiastolic noise "stepwise" in the range of 0.95 s-1.0 s: 42 Hz;

1.0 s-1.2 s: 57 Hz; 1.2 s-1.3 s: 24 Hz and 38 Hz;

- protodiastolic "point" of noise in the coordinates of 0.96 s - 80 Hz;

- presystolic "point" of noise in the coordinates of 1.33 s - 82 Hz.

For II "pair" of heart sounds:

- mesosystolic noise in the range of 1.7 s-1.8 s: 85 Hz-38 Hz;

- mesodiastolic noise in the range of 2.05 s-2.14 s: 40 Hz-70 Hz.

Conclusion according to the results of analysis of acoustocardiogram data:

1. Identified "foci" of incipient systolic and diastolic murmurs, which characterizes the early stage of valve disease of the heart apparatus.

2. The patient needs an in-depth cardiological examination in a hospital setting.

Claims (1)

A protected telemedicine system for the remote detection of early stages of heart disease, including a device for acquiring acoustic heart signals and a device for measuring blood pressure and heart rate, characterized in that the device for acquiring acoustic heart signals and a device for measuring blood pressure and heart rate are connected to a personal computer that is connected to a data encryption module using an electronic digital signature, a data encryption module is connected to the person transmission module patient data via the Internet to a cardiocenter server, which includes a data decryption module connected to a module for displaying blood pressure and heart rate and to a module for acquiring a cardiac acoustocardiogram using multilevel wavelet analysis technology.

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