Novel approach to continuous adventitious respiratory sound analysis for the assessment of bronchodilator response
Lozano García, Manuel (Institut de Bioenginyeria de Catalunya)
Fiz, José Antonio (Institut de Bioenginyeria de Catalunya)
Martínez Rivera, Carlos (Universitat Autònoma de Barcelona. Departament de Medicina)
Torrents, Aurora (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ruiz Manzano, Juan (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Jané Campos, Raimon (Institut de Bioenginyeria de Catalunya)

Date:	2017
Abstract:	Background. A thorough analysis of continuous adventitious sounds (CAS) can provide distinct and complementary information about bronchodilator response (BDR), beyond that provided by spirometry. Nevertheless, previous approaches to CAS analysis were limited by certain methodology issues. The aim of this study is to propose a new integrated approach to CAS analysis that contributes to improving the assessment of BDR in clinical practice for asthma patients. Methods. Respiratory sounds and flow were recorded in 25 subjects, including 7 asthma patients with positive BDR (BDR+), assessed by spirometry, 13 asthma patients with negative BDR (BDR-), and 5 controls. A total of 5149 acoustic components were characterized using the Hilbert spectrum, and used to train and validate a support vector machine classifier, which distinguished acoustic components corresponding to CAS from those corresponding to other sounds. Once the method was validated, BDR was assessed in all participants by CAS analysis, and compared to BDR assessed by spirometry. Results. BDR+ patients had a homogenous high change in the number of CAS after bronchodilation, which agreed with the positive BDR by spirometry, indicating high reversibility of airway obstruction. Nevertheless, we also found an appreciable change in the number of CAS in many BDR- patients, revealing alterations in airway obstruction that were not detected by spirometry. We propose a categorization for the change in the number of CAS, which allowed us to stratify BDR- patients into three consistent groups. From the 13 BDR- patients, 6 had a high response, similar to BDR+ patients, 4 had a noteworthy medium response, and 1 had a low response. Conclusions. In this study, a new non-invasive and integrated approach to CAS analysis is proposed as a high-sensitive tool for assessing BDR in terms of acoustic parameters which, together with spirometry parameters, contribute to improving the stratification of BDR levels in patients with obstructive pulmonary diseases.
Grants:	Agència de Gestió d'Ajuts Universitaris i de Recerca 2014 SGR 1569 Ministerio de Economía y Competitividad DPI2015-68820-R
Note:	IGTP
Note:	Altres ajuts: programa CERCA de la Generalitat de Catalunya
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	PloS one, february 2017, p. 1-23, ISSN 1932-6203

23 p, 4.5 MB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles