Left Ventricular Pressure Estimation Using Machine Learning-Based Heart Sound Classification

P. Westphal, H.X. Luo, M. Shahmohammadi, L.I.B. Heckman, M. Kuiper, F.W. Prinzen, T. Delhaas, R.N. Cornelussen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Web of Science)


ObjectiveA method to estimate absolute left ventricular (LV) pressure and its maximum rate of rise (LV dP/dtmax) from epicardial accelerometer data and machine learning is proposed. MethodsFive acute experiments were performed on pigs. Custom-made accelerometers were sutured epicardially onto the right ventricle, LV, and right atrium. Different pacing configurations and contractility modulations, using isoflurane and dobutamine infusions, were performed to create a wide variety of hemodynamic conditions. Automated beat-by-beat analysis was performed on the acceleration signals to evaluate amplitude, time, and energy-based features. For each sensing location, bootstrap aggregated classification tree ensembles were trained to estimate absolute maximum LV pressure (LVPmax) and LV dP/dtmax using amplitude, time, and energy-based features. After extraction of acceleration and pressure-based features, location specific, bootstrap aggregated classification ensembles were trained to estimate absolute values of LVPmax and its maximum rate of rise (LV dP/dtmax) from acceleration data. ResultsWith a dataset of over 6,000 beats, the algorithm narrowed the selection of 17 predefined features to the most suitable 3 for each sensor location. Validation tests showed the minimal estimation accuracies to be 93% and 86% for LVPmax at estimation intervals of 20 and 10 mmHg, respectively. Models estimating LV dP/dtmax achieved an accuracy of minimal 93 and 87% at estimation intervals of 100 and 200 mmHg/s, respectively. Accuracies were similar for all sensor locations used. ConclusionUnder pre-clinical conditions, the developed estimation method, employing epicardial accelerometers in conjunction with machine learning, can reliably estimate absolute LV pressure and its first derivative.
Original languageEnglish
Article number763048
Number of pages11
JournalFrontiers in cardiovascular medicine
Publication statusPublished - 25 May 2022


  • heart sound
  • hemodynamics
  • cardiac resynchronization therapy
  • artificial intelligence
  • machine learning
  • animal
  • epicardial acceleration

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