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Phono-spectrographic analysis of heart murmur in children

BACKGROUND: More than 90% of heart murmurs in children are innocent. Frequently the skills of the first examiner are not adequate to differentiate between innocent and pathological murmurs. Our goal was to evaluate the value of a simple and low-cost phonocardiographic recording and analysis system i...

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Autores principales: Noponen, Anna-Leena, Lukkarinen, Sakari, Angerla, Anna, Sepponen, Raimo
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1906774/
https://www.ncbi.nlm.nih.gov/pubmed/17559690
http://dx.doi.org/10.1186/1471-2431-7-23
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author Noponen, Anna-Leena
Lukkarinen, Sakari
Angerla, Anna
Sepponen, Raimo
author_facet Noponen, Anna-Leena
Lukkarinen, Sakari
Angerla, Anna
Sepponen, Raimo
author_sort Noponen, Anna-Leena
collection PubMed
description BACKGROUND: More than 90% of heart murmurs in children are innocent. Frequently the skills of the first examiner are not adequate to differentiate between innocent and pathological murmurs. Our goal was to evaluate the value of a simple and low-cost phonocardiographic recording and analysis system in determining the characteristic features of heart murmurs in children and in distinguishing innocent systolic murmurs from pathological. METHODS: The system consisting of an electronic stethoscope and a multimedia laptop computer was used for the recording, monitoring and analysis of auscultation findings. The recorded sounds were examined graphically and numerically using combined phono-spectrograms. The data consisted of heart sound recordings from 807 pediatric patients, including 88 normal cases without any murmur, 447 innocent murmurs and 272 pathological murmurs. The phono-spectrographic features of heart murmurs were examined visually and numerically. From this database, 50 innocent vibratory murmurs, 25 innocent ejection murmurs and 50 easily confusable, mildly pathological systolic murmurs were selected to test whether quantitative phono-spectrographic analysis could be used as an accurate screening tool for systolic heart murmurs in children. RESULTS: The phono-spectrograms of the most common innocent and pathological murmurs were presented as examples of the whole data set. Typically, innocent murmurs had lower frequencies (below 200 Hz) and a frequency spectrum with a more harmonic structure than pathological cases. Quantitative analysis revealed no significant differences in the duration of S1 and S2 or loudness of systolic murmurs between the pathological and physiological systolic murmurs. However, the pathological murmurs included both lower and higher frequencies than the physiological ones (p < 0.001 for both low and high frequency limits). If the systolic murmur contained intensive frequency components of over 200 Hz, or its length accounted for over 80 % of the whole systolic duration, it was considered pathological. Using these criteria, 90 % specificity and 91 % sensitivity in screening were achieved. CONCLUSION: Phono-spectrographic analysis improves the accuracy of primary heart murmur evaluation and educates inexperienced listener. Using simple quantitative criterias a level of pediatric cardiologist is easily achieved in screening heart murmurs in children.
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spelling pubmed-19067742007-07-04 Phono-spectrographic analysis of heart murmur in children Noponen, Anna-Leena Lukkarinen, Sakari Angerla, Anna Sepponen, Raimo BMC Pediatr Research Article BACKGROUND: More than 90% of heart murmurs in children are innocent. Frequently the skills of the first examiner are not adequate to differentiate between innocent and pathological murmurs. Our goal was to evaluate the value of a simple and low-cost phonocardiographic recording and analysis system in determining the characteristic features of heart murmurs in children and in distinguishing innocent systolic murmurs from pathological. METHODS: The system consisting of an electronic stethoscope and a multimedia laptop computer was used for the recording, monitoring and analysis of auscultation findings. The recorded sounds were examined graphically and numerically using combined phono-spectrograms. The data consisted of heart sound recordings from 807 pediatric patients, including 88 normal cases without any murmur, 447 innocent murmurs and 272 pathological murmurs. The phono-spectrographic features of heart murmurs were examined visually and numerically. From this database, 50 innocent vibratory murmurs, 25 innocent ejection murmurs and 50 easily confusable, mildly pathological systolic murmurs were selected to test whether quantitative phono-spectrographic analysis could be used as an accurate screening tool for systolic heart murmurs in children. RESULTS: The phono-spectrograms of the most common innocent and pathological murmurs were presented as examples of the whole data set. Typically, innocent murmurs had lower frequencies (below 200 Hz) and a frequency spectrum with a more harmonic structure than pathological cases. Quantitative analysis revealed no significant differences in the duration of S1 and S2 or loudness of systolic murmurs between the pathological and physiological systolic murmurs. However, the pathological murmurs included both lower and higher frequencies than the physiological ones (p < 0.001 for both low and high frequency limits). If the systolic murmur contained intensive frequency components of over 200 Hz, or its length accounted for over 80 % of the whole systolic duration, it was considered pathological. Using these criteria, 90 % specificity and 91 % sensitivity in screening were achieved. CONCLUSION: Phono-spectrographic analysis improves the accuracy of primary heart murmur evaluation and educates inexperienced listener. Using simple quantitative criterias a level of pediatric cardiologist is easily achieved in screening heart murmurs in children. BioMed Central 2007-06-11 /pmc/articles/PMC1906774/ /pubmed/17559690 http://dx.doi.org/10.1186/1471-2431-7-23 Text en Copyright © 2007 Noponen et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Noponen, Anna-Leena
Lukkarinen, Sakari
Angerla, Anna
Sepponen, Raimo
Phono-spectrographic analysis of heart murmur in children
title Phono-spectrographic analysis of heart murmur in children
title_full Phono-spectrographic analysis of heart murmur in children
title_fullStr Phono-spectrographic analysis of heart murmur in children
title_full_unstemmed Phono-spectrographic analysis of heart murmur in children
title_short Phono-spectrographic analysis of heart murmur in children
title_sort phono-spectrographic analysis of heart murmur in children
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1906774/
https://www.ncbi.nlm.nih.gov/pubmed/17559690
http://dx.doi.org/10.1186/1471-2431-7-23
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