AI-Based Detection of Coronary Artery Occlusion Using Acoustic Biomarkers Before and After Stent Placement

<i>Goal:</i> Cardiovascular disease is the leading cause of death in the USA. Coronary Artery Disease (CAD) in particular is responsible for over 40% of cardiovascular disease deaths. Early detection and treatment are critical in the reduction of deaths associated with CAD. <i>Methods:</i> Sound signatures of CAD vary for individual patients depending on where and how severe the blockage is. We propose the use of the artificial intelligence (AI, specifically the DeepSets architecture) to learn patient-specific acoustic biomarkers which distinguish heart sounds before and after percutaneous coronary intervention (PCI) in 12 human patients. Initially, Matching Pursuit was used to decompose the sound recordings into more granular representations called 'atoms'. Then we used AI to classify whether a group of atoms from a single segment are from before or after PCI. Leveraging the model's learned latent representation, we can then identify groups of atoms which represent CAD-associated sounds within the original recording. <i>Results:</i> Our deep learning approach achieves a test-set classification accuracy of 88.06% using sounds from the full cardiac cycle. The same deep learning architecture achieves 71.43% accuracy using the isolated diastolic window sound segment alone. <i>Conclusions:</i> This preliminary study shows that individualized clusters of atoms represent distinct parts of heart sounds associated with occlusions, and that these clusters differentially change their spectral energy signature after PCI. We believe that using this approach with recordings from individual patients over many time points during disease and treatment progression will allow for a precise, non-invasive monitoring of an individual patient's condition based on unique heart sound characteristics learned using AI.