Key result
Mitral area auscultation yields superior capture of heart sounds and high-frequency murmurs over other sites.
Why the study?
Optimal auscultation sites for wearable phonocardiogram systems in actual patients with valvular heart disease remain unclear.
Does the mitral valve area (P4) optimize the detection of normal heart sounds and high-frequency pathological murmurs using wearable stethoscopes in outpatients with valvular heart disease?
Observational
Does the mitral valve area (P4) optimize the detection of normal heart sounds and high-frequency pathological murmurs using wearable stethoscopes in outpatients with valvular heart disease?
p-value: p=<0.001
The mitral valve area (P4) is the optimal single auscultation site for capturing high-fidelity heart sounds and pathological murmurs using wearable stethoscopes, facilitating home-based non-invasive screening for valvular heart disease.
P4 may optimize wearable PCG site selection; leaves open prospective validation for valvular screening.
Valvular heart disease (VHD) requires continuous monitoring. Wearable phonocardiogram (PCG) systems offer non-invasive screening, but optimal auscultation sites for actual patients remain unclear. To effectively collect heart sounds and pathological murmurs, this study identified the optimal site using wearables in outpatients including VHD patients. PCG signals from five sites were recorded using a digital stethoscope CORE and a smart stethoscope MUST for quantitative analysis. Results showed the mitral valve area (P4) is optimal for capturing normal heart sounds and high-frequency murmurs (80―500 Hz). P4 demonstrated the highest spectral centroid and high-frequency energy ratio, with significantly lower Shannon energy variance (p < 0.001), preserving distinct murmur envelopes without signal-to-noise ratio degradation. Device comparison confirmed the MUST stethoscope (16,000 Hz sampling) fully preserves high-frequency micro-vibrations. In conclusion, measuring at P4 ensures single-site convenience and stable PCG acquisition. These findings facilitate accurate heart sound measurements for general users in home self-care and contribute to designing wearable devices for early screening of VHD.
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Jung et al. (2026) conducted an observational in Valvular heart disease. Phonocardiogram recording at the mitral valve area (P4) vs. Other auscultation sites was evaluated on Optimal capture of normal heart sounds and high-frequency murmurs (measured by spectral centroid, high-frequency energy ratio, and Shannon energy variance) (p=<0.001). Auscultation at the mitral valve area (P4) optimally captured normal heart sounds and high-frequency murmurs with significantly lower Shannon energy variance (p < 0.001) than other sites.
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