The Vote Hides the Failure: Aggregation Choice and Noise Robustness in Heart Murmur Detection

Cardiovascular diseases (CVDs) are the leading cause of death worldwide, accounting for approximately 17.9 million deaths each year. Early detection is critical, creating a demand for accurate and inexpensive pre-screening methods. Deep learning has recently been applied to classify abnormal heart sounds indicative of CVDs using synchronised phonocardiogram (PCG) and electrocardiogram (ECG) signals, as well as multichannel PCG (mPCG). However, state-of-the-art architectures remain underutilised due to the limited availability of synchronised and multichannel datasets. Augmented datasets and pre-trained models provide a pathway to overcome these limitations, enabling transformer-based architectures to be trained effectively. This work combines traditional signal processing with denoising diffusion models, WaveGrad and DiffWave, to create an augmented dataset to fine-tune a Wav2Vec 2.0-based classifier on multimodal and multichannel heart sound datasets. The approach achieves state-of-the-art performance. On the Computing in Cardiology (CinC) 2016 dataset of single channel PCG, accuracy, unweighted average recall (UAR), sensitivity, specificity and Matthew's correlation coefficient (MCC) reach 92.48%, 93.05%, 93.63%, 92.48%, 94.93% and 0.8283, respectively. Using the synchronised PCG and ECG signals of the training-a dataset from CinC, 93.14%, 92.21%, 94.35%, 90.10%, 95.12% and 0.8380 are achieved for accuracy, UAR, sensitivity, specificity and MCC, respectively. Using a wearable vest dataset consisting of mPCG data, the model achieves 77.13% accuracy, 74.25% UAR, 86.47% sensitivity, 62.04% specificity, and 0.5082 MCC. These results demonstrate the effectiveness of transformer-based models for CVD detection when supported by augmented datasets, highlighting their potential to advance multimodal and multichannel heart sound classification.

Heart sound signals, phonocardiography (PCG) signals, allow for the automatic diagnosis of potential cardiovascular pathology. Such classification task can be tackled using the bidirectional long short-term memory (biLSTM) network, trained on features extracted from labeled PCG signals. Regarding the non-stationarity of PCG signals, it is recommended to extract the features from multiple short-length segments of the signals using a sliding window of certain shape and length. However, some window contains unfavorable spectral side lobes, which distort the features. Accordingly, it is preferable to adapt the window shape and length in terms of classification performance. We propose an experimental evaluation for three window shapes, each with three window lengths. The biLSTM network is trained and tested on statistical features extracted, and the performance is reported in terms of the window shapes and lengths. Results show that the best performance is obtained when the Gaussian window is used for splitting the signals, and the triangular window competes with the Gaussian window for a length of 75 ms. Although the rectangular window is a commonly offered option, it is the worst choice for splitting the signals. Moreover, the classification performance obtained with a 75 ms Gaussian window outperforms that of a baseline method.

In this paper, we introduce Synthetic Heart Sound Detection (SHAC), a task aimed at identifying phonocardiograms (PCGs) synthesized using neural audio codecs (NACs). To facilitate research in this direction, we release CARDIOFAKE, the first benchmark dataset for SHAC containing both real and codec-synthesized PCGs. We benchmark spectral representations (MFCC, LFCC) and self-supervised learning (SSL) representations (e.g., WavLM) for the task. Furthermore, we propose GROOT, a fusion framework that integrates spectral and SSL features for leveraging their complementary behavior. Experiments show that GROOT, combining MFCC and WavLM, achieves state-of-the-art performance, outperforming individual representations and competitive baselines.