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- Researchers assessed the feasibility of using a smartphone\u2019s inbuilt microphone to record heart sounds by investigating the quality of smartphone-recorded heart sounds and the factors influencing the quality of the recordings.<\/strong><\/li>\n
- Overall, three out of four recordings were of good quality, meaning that they could be processed further to obtain medically relevant data.<\/strong><\/li>\n
- The results indicate that heart sound quality is not influenced by phone version or by the user\u2019s biological sex, but users aged over 60 seemed to have lower-quality recordings.<\/strong><\/li>\n
- This study paves the way for a future where individuals, particularly those with heart problems, can easily record their own heart sounds at home, thus improving the diagnostic process.<\/strong><\/li>\n<\/ul>\n
Everyone is familiar with the \u201club-dub\u2026 lub-dub\u201d sounds the heart makes. The reason that the heart makes these sounds is related to its function of circulating blood throughout the body.<\/p>\n
The heart muscle pumps blood by continuously contracting and relaxing. During contraction of the heart, we hear the \u201club\u201d sound, known as the first heart sound, S1, and during relaxation of the heart, we hear the \u201cdub\u201d sound \u2014the second heart sound, S2.<\/p>\n
The traditional tool used by doctors to listen to heart sounds is the stethoscope<\/a>.<\/p>\n
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Heart sounds may be a useful marker in heart failure<\/a>, but currently, they are only assessed in a clinical setting. It would be useful for patients to be able to record their own heart sounds when they are at home.<\/strong><\/p>\n
One possible way in which heart sounds may be easily captured by individuals in the comfort of their own homes is by using a smartphone with an inbuilt high-quality microphone. To date, several mobile app prototypes for recording heart sounds have been developed and made available to the public, including
iStethoscope<\/a><\/hl-trusted-source> and CPstethoscope<\/a><\/hl-trusted-source>.<\/p>\n Now, researchers at King\u2019s College London in the United Kingdom and Maastricht University in the Netherlands have conducted a study to investigate the feasibility of using a smartphone as a stethoscope and to assess the potential factors that influence the quality of heart sound recordings.<\/p>\n
\u201cThis research proves that mobile technologies are a viable way of recording heart sounds and that in the future, cardiac patients and doctors could use at-home recordings to check for [the] existence or progression of heart conditions,\u201d says Dr. Pablo Lamata<\/a>, study co-author and professor of biomedical engineering at King\u2019s College London.<\/p>\n
The results of this study appeared in the European Heart Journal \u2013 Digital Health<\/a>.<\/em><\/p>\n
In collaboration with cardiac patients through the\u00a0British Heart Foundation<\/a> (BHF)\u00a0and\u00a0Evelina Children\u2019s Heart Organization<\/a> (ECHO), and with experts at\u00a0Cellule Design Studio<\/a>, the researchers developed a smartphone application that measures heart sound.<\/p>\n
To use the Echoes app<\/a>, the user only needs to place their smartphone on their chest and press \u201crecord.\u201d The application has a signal processing algorithm that filters the heart sound recordings to remove any background noise.<\/strong><\/p>\n
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The Echoes app asks users to voluntarily provide anonymous basic demographics including age, sex, height, weight, and, if applicable, any heart conditions.<\/p>\n
Between May 21 and October 4, 2021, 1,148 individuals downloaded the Echoes app and contributed 7,597 heart sound recordings, which were uploaded to a Google Firebase database.<\/p>\n
The researchers found that eight out of 10 (80%) users were able to make a good quality heart sound recording. A \u201cgood quality\u201d recording is one that can be interpreted for analysis.<\/p>\n
Overall, three out of four (75%) recordings could be processed further to obtain medically relevant data.<\/strong><\/p>\n
The researchers then looked at the factors affecting the quality of the heart sound recordings among these users. They found that the following factors do not impact the quality of the recordings:<\/p>\n
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- phone version<\/li>\n
- user\u2019s biological sex.<\/li>\n<\/ul>\n
However, the researchers observed that users aged over 60 had lower-quality recordings.<\/p>\n
During his doctoral thesis defense, Dr. Hongxing Luo<\/a>, study co-author and postdoctoral researcher at Maastricht University argued that the issue of low-quality heart sound recordings by older users can be overcome.<\/p>\n
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One of the easiest solutions, he said, is to instruct the users to use an earpiece to listen to their heart sounds while they search for the position with the loudest heart sounds.<\/strong><\/p>\n
Since hospitals already have several tools to evaluate the heart conditions of patients, such as an echocardiogram<\/a> (ECG) and
magnetic resonance imaging<\/a><\/hl-trusted-source> (MRI<\/a>) scans, Dr. Luo believes that the most promising direction for technology like Echoes is remote heart monitoring, especially for the following patient categories:<\/p>\n - \n
- heart failure patients<\/li>\n
- post-operative follow-up of patients with valvular heart disease<\/a><\/li>\n
- post-operative follow-up of arrhythmia<\/a> patients.<\/li>\n<\/ul>\n
Dr. Lamata described the Echoes app as \u201ca tool to empower patient[s] to manage their own conditions.\u201d<\/p>\n
Dr. James Leiper<\/a>, professor of molecular medicine at the University of Glasgow and Associate Medical Director at the British Heart Foundation, notes:<\/p>\n
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\u201cAs we enter the age of digital medicine, technology like Echoes could revolutionize the diagnosis and at-home monitoring of heart conditions. Further research is needed to test how the app can be used in tandem with existing heart monitoring techniques. However, if successful, this development could mark an important step towards having heart monitoring tools at your fingertips.\u201d<\/p>\n<\/blockquote>\n
Dr. Dominik Linz<\/a>, professor in the physiology<\/a> of circulation, kidney, and lung at the University of Copenhagen, pointed out that it is important for researchers to identify \u201cspecific thresholds for [heart sound measurements] which should result in action\u201d by the cardiologist assessing the patient\u2019s data via the Echoes app.<\/p>\n
One study limitation is that the Echoes app was only available for iPhone users, thus excluding Android users \u2014 who account for more than half of overall smartphone users \u2014 from the study.<\/p>\n
When asked if the Echoes app would become available to the wider public, Dr. Pablo Lamata, told Medical News Today<\/em>: \u201cWe are now planning our next release, to also include an Android version, hopefully by May next year.\u201d<\/strong><\/p>\n
The Echoes app currently only detects the S1 and S2 heart sounds, and the researchers commented that \u201cthe usefulness of recognizing pathological heart sounds including S3, S4, and murmurs, has to be investigated in a future study involving patients.\u201d<\/p>\n
The researchers also noted that the study population may not reflect a truly general population \u201cbecause smartphone users are likely younger and more educated.\u201d Further research is needed to assess the reproducibility of these results.<\/p>\n
- post-operative follow-up of arrhythmia<\/a> patients.<\/li>\n<\/ul>\n
- Overall, three out of four recordings were of good quality, meaning that they could be processed further to obtain medically relevant data.<\/strong><\/li>\n