WO2017159753A1 - Dispositif de détection de bruit cardiaque systolique - Google Patents

Dispositif de détection de bruit cardiaque systolique Download PDF

Info

Publication number
WO2017159753A1
WO2017159753A1 PCT/JP2017/010507 JP2017010507W WO2017159753A1 WO 2017159753 A1 WO2017159753 A1 WO 2017159753A1 JP 2017010507 W JP2017010507 W JP 2017010507W WO 2017159753 A1 WO2017159753 A1 WO 2017159753A1
Authority
WO
WIPO (PCT)
Prior art keywords
sound
heart
systolic
noise
systole
Prior art date
Application number
PCT/JP2017/010507
Other languages
English (en)
Japanese (ja)
Inventor
晋平 小川
Original Assignee
Ａｍｉ株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ａｍｉ株式会社 filed Critical Ａｍｉ株式会社
Publication of WO2017159753A1 publication Critical patent/WO2017159753A1/fr

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B7/00—Instruments for auscultation
    • A61B7/02—Stethoscopes
    • A61B7/04—Electric stethoscopes

Definitions

  • the present invention relates to an apparatus for detecting cardiac noise during a systole of a heart from an electrocardiogram signal and a heart sound signal.
  • Aortic stenosis is a cause of sudden death, fainting, chest pain, and heart failure, and prior diagnosis is important.
  • doctors usually determine whether there is an abnormal heart noise by auscultation, and if there is an abnormality, follow a procedure such as performing an echocardiogram. .
  • an object of the present invention is to provide an apparatus capable of automatically detecting cardiac noise that may cause a disease such as aortic stenosis without experience.
  • the invention described in claim 1 includes an electrocardiogram signal receiving unit that receives an electrocardiogram signal, a heart sound signal receiving unit that receives a heart sound signal, and a systolic phase extracting unit that extracts the approximate systolic time of the heart from the electrocardiogram signal;
  • the systolic heart noise detecting device includes a systolic heart noise determining unit that determines whether or not heart noise is present in the heart sound at the time extracted by the systolic extracting unit from the heart sound signal.
  • the signal in the present application includes both an analog signal and a digital signal (data).
  • the electrocardiogram signal is sufficient as a minimum electrocardiogram signal that can determine the systole and diastole of the heart
  • the heart sound signal is a sound obtained from a body surface near the heart via a sound collector such as a stethoscope. Signal.
  • the systolic heart murmur determination unit includes one sound and / or one in the heart sound at a time extracted from the heart sound signal by the systolic extraction unit. Alternatively, it is detected whether there is a sound other than two sounds, and it is determined whether there is heart noise based on the detection result.
  • the systolic heart murmur determination unit does not need to detect whether a sound other than two sounds is present.
  • the systolic noise determination unit has the same sound other than the one sound and / or two sounds in a plurality of systolic periods.
  • systolic heart murmur detection device When it is detected at the timing, it is determined that there is cardiac noise.
  • sounds other than the one sound and / or two sounds are detected at the same timing in the time of ten or more consecutive systoles. In this case, it is determined that there is heart noise.
  • the systolic heart murmur determination unit is configured to generate a sound other than the one sound and / or two sounds when a sound having an amplitude exceeding a predetermined threshold is present after a predetermined time has elapsed from the start of the systole to the end of the systole. Is detected.
  • the systolic heart noise detecting device when it is detected whether a sound other than one sound is present, the systolic heart noise is detected.
  • the determination unit detects whether there is a sound other than two sounds, the sound having an amplitude exceeding a predetermined threshold is present between the start of the systole and a predetermined time before the end of the systole. It detects the presence of a sound other than two sounds.
  • the invention according to claim 6 is a program for causing a computer to realize a function as the systolic heartbeat detection device.
  • the computer includes various devices such as a smart phone, a tablet computer, and a portable information terminal that have a CPU and a function that operates by incorporating a program.
  • the present invention has the following effects. According to the first and second aspects of the present invention, it is possible to automatically obtain a heart murmur during the systole of the heart that occurs in a disease such as aortic valve stenosis. Then, by determining whether or not the systole is based on the electrocardiogram data, it is possible to make an accurate and automatic determination.
  • the invention according to claim 3 can reduce misjudgment due to normal noise such as breathing sound by measuring the systole multiple times.
  • the invention according to claim 4 can reduce erroneous determination due to breathing sound or the like more reliably by measuring the systole 10 times or more.
  • the fifth aspect of the present invention since one sound having a peak at the start of the systole attenuates in a short time from the systole, whether or not there is a sound having an amplitude greater than or equal to a predetermined threshold in the systole except this period. Therefore, it is possible to easily extract a sound other than a single sound that may cause heart noise.
  • the sixth aspect of the invention since two sounds are generated at the end of the systole, if it is determined whether there is a sound having an amplitude equal to or greater than a predetermined threshold in the systole except for this period, two sounds are easily obtained. It is possible to extract sounds other than sounds that have the possibility of heart noise.
  • the invention according to claim 7 is a non-medical worker who is not in a medical institution or a medical examination center by himself / herself in a systolic heart by incorporating the program such as a smartphone and connecting a terminal capable of acquiring electrocardiogram data and electrocardiogram data. Noise can be measured.
  • FIG. 1 It is a block diagram which shows typically the hardware constitutions of the systolic heart noise detection apparatus which concerns on embodiment.
  • A is a perspective view of the surface side which shows the example of the stethoscope with the electrode for electrocardiograms
  • (b) is a perspective view of the back side which shows the example of the stethoscope with the electrodes for electrocardiogram.
  • (A) is a figure which shows an example of an electrocardiogram signal
  • (b) is a figure which decomposes
  • FIG. 1 is a block diagram schematically showing the hardware configuration of the systolic heart noise detection device X according to the embodiment.
  • the systolic heartbeat detection device X stores a CPU 11 that performs arithmetic processing, a RAM 12 that is a work area of the CPU, a ROM 13 that stores basic programs and data, a clock 14 that takes CPU operation timing, and data and programs.
  • a monitor 16 Connected to an external recording device 15 such as an SSD, a monitor 16 having a touch panel for inputting data and displaying information, electrocardiogram electrodes 20a, 20b and 20c of a stethoscope Y with an electrocardiogram electrode to be described later, and an auscultation unit 30 And an analog interface 17 including an AD converter.
  • the systolic heart murmur detection device X is formed by incorporating a program for realizing the operation described below into such hardware.
  • these hardware is stored in the housing
  • FIG. 2A shows a perspective view of the distal end portion of the stethoscope Y with an electrocardiogram electrode connected to the analog interface 17 as viewed obliquely from above
  • FIG. 2B shows the distal end portion of the stethoscope Y with an electrocardiogram electrode obliquely downward.
  • the perspective view seen from is shown.
  • the stethoscope Y with an electrocardiogram electrode includes three electrocardiogram electrodes 20a, 20b, 20c, an auscultation unit 30, and an electric cable 40.
  • the auscultation unit 30 has substantially the same structure as a chest piece portion of a general diaphragm type stethoscope, but has a built-in microphone for converting sound into an electrical signal.
  • the electrocardiogram electrodes 20a, 20b, and 20c are electrodes arranged in a regular triangle around the auscultation unit 30, and constitute a plus electrode, a minus electrode, and a ground electrode, respectively.
  • the electrocardiogram electrodes 20a, 20b, and 20c are fixed in an elastomer cover that is integrally fixed to the auscultation unit 30 on the back side, the exposed surfaces of the electrocardiogram electrodes 20a, 20b, and 20c and the diaphragm of the auscultation unit 30
  • the surface of the electrocardiogram electrode 20a, 20b, and 20c is exposed to the body when the diaphragm surface of the auscultation unit 30 is brought into contact with the body surface of the heart portion. It is formed so as to be in proper contact with the surface.
  • the electric wires electrically connected to the electrocardiogram electrodes 20a, 20b, and 20c and the electric wires connected to the microphone incorporated in the auscultation unit 30 are connected to the analog interface 17 of the systolic heart noise detector X via the electric cable 40.
  • FIG. 3 is a functional block diagram schematically showing the function of the systolic heart noise detector X. It has an electrocardiogram signal reception unit 101, an electrocardiogram signal reception unit 102, a systolic extraction unit 103, and a cardiac noise determination unit 104.
  • the electrocardiogram signal receiving unit 101 receives an electrocardiogram signal transmitted from the electrocardiogram electrodes 20a, 20b, and 20c of the stethoscope Y with the electrocardiogram electrode.
  • FIG. 4A shows an example of an electrocardiogram obtained based on the electrocardiogram electrodes 20a, 20b, and 20c. There are P waves, Q waves, R waves, S waves, and T waves in the electrocardiogram.
  • the heart sound signal receiving unit 102 receives a signal sent from the built-in microphone of the auscultation unit 30 of the stethoscope Y with an electrocardiogram electrode.
  • FIG. 4B shows an example of sounds around the heart collected by the auscultation unit 30.
  • a heart sound is a sound generated with the heartbeat and is generated as an I sound (single sound), an II sound (two sounds), a III sound (three sounds), or an IV sound (four sounds).
  • the I sound occurs immediately after the start of the systole of the heart
  • the II sound occurs at the boundary between the systole and the diastole.
  • the heart murmur is a sound that occurs with the heartbeat but does not occur in a normal heart.
  • the systolic heart murmur detector X aims to detect this murmur during systole.
  • a breathing sound or the like is a normal sound generated by an internal activity such as breathing in addition to the heart. Since the auscultation unit 30 converts a sound in which these sounds are overlapped into an electric signal with a microphone, the heart sound signal received by the heart sound data receiving unit 102 is received as a multiple of sounds around the heart.
  • the systole extraction unit 103 extracts the systole of the heart based on the electrocardiogram signal received by the electrocardiogram signal reception unit 101. Specifically, an R wave and a T wave are extracted from the electrocardiogram shown in FIG. 4A, and a period from the peak of the R wave to the end of the T wave is defined as a systole. However, since the II sound (two sounds) is generated at the end of the T wave, the time from the end of the T wave until the end of the systole is set so that the II sound (two sounds) is not included here. suddenly.
  • the cardiac noise determination unit 104 determines whether there is cardiac noise in the systole extracted by the systolic determination unit 103.
  • the cardiac noise determination unit 104 includes a cardiac noise detection unit 104a and a determination unit 104b.
  • the cardiac noise detection unit 104a detects whether there is a sound having an amplitude exceeding a predetermined threshold between 0.3 seconds after the start of the systole extracted by the systole extraction unit 103 and the end of the systole.
  • the threshold value can be appropriately set such as obtaining from the amplitude of the I sound (one sound) or using an absolute value obtained by an experiment or the like.
  • the reason for determining from 0.3 seconds after the start of the systole is that the I sound (one sound) always exists as a loud sound at the beginning of the systole, so that the time until it becomes sufficiently small is excluded.
  • the cardiac noise detection unit 104a records the generation timing within the systole.
  • the determination unit 104b determines that there is cardiac noise when the cardiac noise detection unit 104a performs detection in 10 consecutive systoles, and there is a sound that exceeds the threshold at the same timing in all 10 times. .
  • the determination based on the ten systoles is to eliminate the influence of noise such as breathing sound, and the influence of the breathing sound can be eliminated by measuring about ten times from the breathing timing.
  • the number of times is not limited to 10 and may be changed as appropriate.
  • the determination criterion that there is a sound that exceeds the threshold value in all ten systoles is also an example, and the determination condition is also changed as appropriate, such as determining that there is cardiac noise even when the frequency threshold value less than 10 is exceeded. Can do.
  • FIG. 6 is a flowchart showing the operation according to FIG.
  • the examiner examines the stethoscope Y with the electrocardiogram electrode so that the auscultation unit 30 and the electrocardiogram electrodes 20a to 20c are in firm contact with the body surface of the examinee with the electrocardiogram electrode 20a facing down. Press against the person's heart.
  • an electrocardiogram signal is sent from the electrocardiogram electrodes 20a to 20c, and a heart sound signal is sent from the auscultation unit 30 to the systolic heart noise detector X.
  • the electrocardiogram signal reception unit 101 receives the electrocardiogram signal, and the heart sound signal
  • the accepting unit 102 accepts a heart sound signal (s101).
  • the systolic extraction unit 103 extracts the systole of the heart based on the accepted electrocardiogram signal (s102).
  • the heart noise detection unit 104 of the heart noise determination unit 104 increments the variable corresponding to the number of examinations by one (s103), and the heart sound received in the period excluding the first 0.3 seconds of the extracted systole. It is determined whether the amplitude of the signal exceeds a predetermined threshold (s104). If the threshold is not exceeded, the determination unit 104b determines that there is no cardiac noise.
  • the cardiac noise detection unit 104a records the timing in excess (s105). The above operations from s103 to s105 are repeated until the variable becomes 10 (s106).
  • the determination unit 104b of the cardiac noise determination unit 104 has a timing when the threshold is exceeded. Are all the same in 10 times. (S107). Here, if all have the same timing, it is determined that there is cardiac noise (s108), and if there is a different timing, it is determined that there is no cardiac noise (s109). Thereafter, the determination result by the cardiac noise determination unit 104 is displayed on the monitor 16 and recorded in association with the examinee information (s110), and the process ends.
  • the systolic heart murmur detection device X detects the systolic heart murmur that has been extracted by human experience, and extracts the systolic rhythm of the heart from the electrocardiogram signal. By using this, it is possible to automatically determine whether there is heart noise during the systole.
  • the systolic heart noise detection device is exemplified as a dedicated device.
  • application software that realizes the above operation is incorporated in a smartphone, and an electrocardiogram electrode is formed so as to be connectable to the smartphone.
  • the smartphone can be used as a systolic heartbeat detection device. This makes it possible for the examinee himself to easily detect systolic heart noise at home.
  • a stethoscope with an electrocardiogram electrode is connected to the systolic heart noise detection device so as to directly receive an electrocardiogram signal and a heart sound signal.
  • the electrocardiogram signal and the heart sound signal are analyzed by the CPU as digital data, but it is also possible to perform the analog signal as it is until it is determined whether the heart sound signal exceeds the threshold value. Then, when the heart noise detection unit detects whether the heart sound signal exceeds the threshold value 10 times, after acquiring the electrocardiogram signal and the heart sound signal at the heart rate of 10 times, it is determined whether the threshold value is exceeded each time. Alternatively, each time an electrocardiogram signal and a heart sound signal corresponding to one heartbeat are received, it may be detected whether the heart sound signal exceeds a threshold value.
  • the heart sound signal exceeds the threshold value after 0.3 second of the systole, but the I sound (single sound).
  • the I sound single sound
  • an I sound one sound is estimated based on 10 heart sound signals at the peak of the R wave of the electrocardiogram, and this waveform is subtracted from the heart sound signal, Other methods such as determining whether or not the threshold value is exceeded with respect to the value obtained by subtracting the average I sound waveform data may be employed.
  • the end time is extracted slightly earlier so that the II sound (two sounds) is not included in the systole, but the time until the II sound (two sounds) is included is extracted as the systole.
  • processing may be performed so as not to be confused with heart noise by subtracting the estimated waveform of the II sound (two sounds).
  • X Systolic heart noise detection device Y Stethoscopes 20a, 20b, 20c with electrocardiogram electrodes Electrocardiogram electrode 30 Auscultation unit 101 Electrocardiogram signal reception unit 102 Heart sound signal reception unit 103 Systole extraction unit 104 Heart noise determination unit 104a Heart noise detection unit 104b Judgment part

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Cardiology (AREA)
  • Physics & Mathematics (AREA)
  • Animal Behavior & Ethology (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Acoustics & Sound (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)

Abstract

Le problème décrit par la présente invention est de fournir un dispositif grâce auquel il est possible de détecter automatiquement un bruit cardiaque pouvant indiquer la présence de maladies telles qu'une sténose aortique ou similaire sans nécessiter d'expérience en la matière. La solution de la présente invention concerne un dispositif de détection de bruit cardiaque systolique comprenant : une unité de réception de signal d'électrocardiogramme qui reçoit des signaux d'électrocardiogramme ; une unité de réception de signal de bruit cardiaque qui reçoit des signaux de bruit cardiaque ; une unité d'identification de systole qui identifie, dans les signaux d'électrocardiogramme, une période pendant laquelle le cœur est en systole ; et une unité de détermination de bruit cardiaque systolique qui détecte la présence/l'absence de sons autres que le premier bruit et/ou le second bruit du bruit cardiaque pendant la période identifiée dans les signaux de bruit cardiaque par l'unité d'identification de systole, et qui détermine la présence/l'absence de bruit cardiaque sur la base des résultats de détection.
PCT/JP2017/010507 2016-03-18 2017-03-15 Dispositif de détection de bruit cardiaque systolique WO2017159753A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2016055892A JP2017169615A (ja) 2016-03-18 2016-03-18 収縮期心雑音検出装置
JP2016-055892 2016-03-18

Publications (1)

Publication Number Publication Date
WO2017159753A1 true WO2017159753A1 (fr) 2017-09-21

Family

ID=59851582

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2017/010507 WO2017159753A1 (fr) 2016-03-18 2017-03-15 Dispositif de détection de bruit cardiaque systolique

Country Status (2)

Country Link
JP (1) JP2017169615A (fr)
WO (1) WO2017159753A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108236462A (zh) * 2018-02-26 2018-07-03 河南善仁医疗科技有限公司 心电心音传感器一体式敷贴
CN108324268A (zh) * 2018-02-26 2018-07-27 河南善仁医疗科技有限公司 一种心电图心音图的分析方法

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN114206222A (zh) * 2019-07-26 2022-03-18 富士胶片株式会社 听诊器

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH03133426A (ja) * 1989-10-19 1991-06-06 Mitsui Eng & Shipbuild Co Ltd 心音計
JP2008539895A (ja) * 2005-05-05 2008-11-20 カーディアック・ペースメーカーズ・インコーポレーテッド 収縮期雑音強度の傾向付け
JP2011212364A (ja) * 2010-04-01 2011-10-27 Sharp Corp 心音測定装置
JP2013034670A (ja) * 2011-08-08 2013-02-21 Jvc Kenwood Corp 心音情報処理装置、心音情報処理方法、心音情報処理プログラム

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH03133426A (ja) * 1989-10-19 1991-06-06 Mitsui Eng & Shipbuild Co Ltd 心音計
JP2008539895A (ja) * 2005-05-05 2008-11-20 カーディアック・ペースメーカーズ・インコーポレーテッド 収縮期雑音強度の傾向付け
JP2011212364A (ja) * 2010-04-01 2011-10-27 Sharp Corp 心音測定装置
JP2013034670A (ja) * 2011-08-08 2013-02-21 Jvc Kenwood Corp 心音情報処理装置、心音情報処理方法、心音情報処理プログラム

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108236462A (zh) * 2018-02-26 2018-07-03 河南善仁医疗科技有限公司 心电心音传感器一体式敷贴
CN108324268A (zh) * 2018-02-26 2018-07-27 河南善仁医疗科技有限公司 一种心电图心音图的分析方法

Also Published As

Publication number Publication date
JP2017169615A (ja) 2017-09-28

Similar Documents

Publication Publication Date Title
US9008762B2 (en) Method and apparatus for identifying cardiac risk
US9492138B2 (en) Mobile front-end system for comprehensive cardiac diagnosis
US8688202B2 (en) Method and apparatus for identifying cardiac risk
AU2017273194B2 (en) Method and arrangement for monitoring specific activity parameters of the human heart
JP5889197B2 (ja) 身体動きモニタリングデバイス
US8548577B2 (en) Detection of electrical and mechanical cardio-vascular activities
WO2013191932A1 (fr) Mesure en temps réel de la durée du segment qrs d'un électrocardiogramme
US20180116626A1 (en) Heart Activity Detector for Early Detection of Heart Diseases
EP3141190A1 (fr) Procédé de détection de fréquence cardiaque et dispositif utilisant un son cardiaque acquis à partir de positions d'auscultation
CN104352229A (zh) 一种基于健康监测手环的自助房颤检测方法
WO2017159753A1 (fr) Dispositif de détection de bruit cardiaque systolique
Mora et al. Fully automated annotation of seismocardiogram for noninvasive vital sign measurements
JP2007236534A (ja) Ｒｒ間隔指標を取得する方法およびシステム
WO2016113687A1 (fr) Moniteur cardiaque portable basé sur des ultrasons doppler
Gavriel et al. Smartphone as an ultra-low cost medical tricorder for real-time cardiological measurements via ballistocardiography
US20140213921A1 (en) Method and Apparatus for Identifying Cardiac Risk
Luo Portable Bluetooth visual electrical stethoscope research
Mann et al. Heart Rate Monitoring Using Heart Acoustics
KR100821919B1 (ko) 심장 혈관계 진단 패치
JP7320867B2 (ja) 医療機器及びプログラム
Such et al. On-body sensors for personal healthcare
Monika et al. Embedded Stethoscope for Real Time Diagnosis of Cardiovascular Diseases
EP3501401B1 (fr) Appareil et procédé d'auscultation
EP3692922A1 (fr) Système et procédé d'identification d'un emplacement du c ur responsable d'un son particulier
CN115768352A (zh) 起搏脉冲检测和起搏伪影抑制的方法及系统

Legal Events

Date Code Title Description
NENP Non-entry into the national phase

Ref country code: DE

121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 17766749

Country of ref document: EP

Kind code of ref document: A1

122 Ep: pct application non-entry in european phase

Ref document number: 17766749

Country of ref document: EP

Kind code of ref document: A1