Stratification of Heart Sounds Morphology Through Unsupervised Learning

The use of heart sounds for the assessment of the hemodynamic condition of the heart in telemonitoring applications is object of wide research at date. Many different approaches have been tried out for the analysis of the first (S1) and second (S2) heart sounds, but their morphological interpretation is still to be explored: in fact, the sound morphology is not unique and this impact the separability of the heart sounds components with methods based on envelopes or model optimization. In this study, we propose a method to stratify S1 and S2 according to their morphology to explore their diversity and increase their morphological interpretability. The method we propose is based on unsupervised learning, which we obtain using the cascade of four Self-Organizing Maps (SOMs) of decreasing dimensions. When tested on a publicly available heart sounds dataset, the proposed clustering approach proved to be robust and consistent, with over 80% of the heartbeats of the same patient being clustered together. The identified heart sounds templates highlight differences in the time and energy domains which may open to new directions of analysis in the future.