{"id":"https://openalex.org/W4405492260","doi":"https://doi.org/10.1109/embc53108.2024.10782371","title":"Explainable Multimodal Deep Learning for Heart Sounds and Electrocardiogram Classification","display_name":"Explainable Multimodal Deep Learning for Heart Sounds and Electrocardiogram Classification","publication_year":2024,"publication_date":"2024-07-15","ids":{"openalex":"https://openalex.org/W4405492260","doi":"https://doi.org/10.1109/embc53108.2024.10782371","pmid":"https://pubmed.ncbi.nlm.nih.gov/40039014"},"language":"en","primary_location":{"id":"doi:10.1109/embc53108.2024.10782371","is_oa":false,"landing_page_url":"https://doi.org/10.1109/embc53108.2024.10782371","pdf_url":null,"source":null,"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"2024 46th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)","raw_type":"proceedings-article"},"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5077435291","display_name":"Bruno Oliveira","orcid":"https://orcid.org/0000-0002-7710-4284"},"institutions":[{"id":"https://openalex.org/I182534213","display_name":"Universidade do Porto","ror":"https://ror.org/043pwc612","country_code":"PT","type":"education","lineage":["https://openalex.org/I182534213"]},{"id":"https://openalex.org/I4210166615","display_name":"INESC TEC","ror":"https://ror.org/05fa8ka61","country_code":"PT","type":"nonprofit","lineage":["https://openalex.org/I4210125590","https://openalex.org/I4210166615"]}],"countries":["PT"],"is_corresponding":true,"raw_author_name":"Bruno Oliveira","raw_affiliation_strings":["University of Porto,INESC-TEC and Faculty of Sciences,Porto,Portugal"],"affiliations":[{"raw_affiliation_string":"University of Porto,INESC-TEC and Faculty of Sciences,Porto,Portugal","institution_ids":["https://openalex.org/I182534213","https://openalex.org/I4210166615"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5103911194","display_name":"Andr\u00e9 Lobo","orcid":null},"institutions":[{"id":"https://openalex.org/I4210141686","display_name":"Centro Hospitalar de Vila Nova de Gaia","ror":"https://ror.org/042jpy919","country_code":"PT","type":"healthcare","lineage":["https://openalex.org/I4210141686"]}],"countries":["PT"],"is_corresponding":false,"raw_author_name":"Andr\u00e9 Lobo","raw_affiliation_strings":["Centro Hospitalar de Vila Nova de Gaia/Espinho,Department of Cardiology,Vila Nova de Gaia,Portugal"],"affiliations":[{"raw_affiliation_string":"Centro Hospitalar de Vila Nova de Gaia/Espinho,Department of Cardiology,Vila Nova de Gaia,Portugal","institution_ids":["https://openalex.org/I4210141686"]}]},{"author_position":"middle","author":{"id":null,"display_name":"C\u00e1tia Isabel Costa","orcid":null},"institutions":[{"id":"https://openalex.org/I4210141686","display_name":"Centro Hospitalar de Vila Nova de Gaia","ror":"https://ror.org/042jpy919","country_code":"PT","type":"healthcare","lineage":["https://openalex.org/I4210141686"]}],"countries":["PT"],"is_corresponding":false,"raw_author_name":"C\u00e1tia Isabel Costa","raw_affiliation_strings":["Centro Hospitalar de Vila Nova de Gaia/Espinho,Department of Cardiology,Vila Nova de Gaia,Portugal"],"affiliations":[{"raw_affiliation_string":"Centro Hospitalar de Vila Nova de Gaia/Espinho,Department of Cardiology,Vila Nova de Gaia,Portugal","institution_ids":["https://openalex.org/I4210141686"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5019030595","display_name":"Ricardo Fontes\u2010Carvalho","orcid":"https://orcid.org/0000-0003-2306-8393"},"institutions":[{"id":"https://openalex.org/I182534213","display_name":"Universidade do Porto","ror":"https://ror.org/043pwc612","country_code":"PT","type":"education","lineage":["https://openalex.org/I182534213"]}],"countries":["PT"],"is_corresponding":false,"raw_author_name":"Ricardo Fontes-Carvalho","raw_affiliation_strings":["Faculty of Medicine of the University of Porto,Cardiovascular Research & Development Center - UnIC@RISE,Department of Surgery and Physiology,Porto,Portugal"],"affiliations":[{"raw_affiliation_string":"Faculty of Medicine of the University of Porto,Cardiovascular Research & Development Center - UnIC@RISE,Department of Surgery and Physiology,Porto,Portugal","institution_ids":["https://openalex.org/I182534213"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5038594477","display_name":"Miguel Coimbra","orcid":"https://orcid.org/0000-0001-7501-6523"},"institutions":[{"id":"https://openalex.org/I182534213","display_name":"Universidade do Porto","ror":"https://ror.org/043pwc612","country_code":"PT","type":"education","lineage":["https://openalex.org/I182534213"]},{"id":"https://openalex.org/I4210166615","display_name":"INESC TEC","ror":"https://ror.org/05fa8ka61","country_code":"PT","type":"nonprofit","lineage":["https://openalex.org/I4210125590","https://openalex.org/I4210166615"]}],"countries":["PT"],"is_corresponding":false,"raw_author_name":"Miguel Coimbra","raw_affiliation_strings":["University of Porto,INESC-TEC and Faculty of Sciences,Porto,Portugal"],"affiliations":[{"raw_affiliation_string":"University of Porto,INESC-TEC and Faculty of Sciences,Porto,Portugal","institution_ids":["https://openalex.org/I182534213","https://openalex.org/I4210166615"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5057294055","display_name":"Francesco Renna","orcid":null},"institutions":[{"id":"https://openalex.org/I182534213","display_name":"Universidade do Porto","ror":"https://ror.org/043pwc612","country_code":"PT","type":"education","lineage":["https://openalex.org/I182534213"]},{"id":"https://openalex.org/I4210166615","display_name":"INESC TEC","ror":"https://ror.org/05fa8ka61","country_code":"PT","type":"nonprofit","lineage":["https://openalex.org/I4210125590","https://openalex.org/I4210166615"]}],"countries":["PT"],"is_corresponding":false,"raw_author_name":"Francesco Renna","raw_affiliation_strings":["University of Porto,INESC-TEC and Faculty of Sciences,Porto,Portugal"],"affiliations":[{"raw_affiliation_string":"University of Porto,INESC-TEC and Faculty of Sciences,Porto,Portugal","institution_ids":["https://openalex.org/I182534213","https://openalex.org/I4210166615"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":6,"corresponding_author_ids":["https://openalex.org/A5077435291"],"corresponding_institution_ids":["https://openalex.org/I182534213","https://openalex.org/I4210166615"],"apc_list":null,"apc_paid":null,"fwci":2.4041,"has_fulltext":false,"cited_by_count":6,"citation_normalized_percentile":{"value":0.89910972,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":98,"max":99},"biblio":{"volume":"2024","issue":null,"first_page":"1","last_page":"4"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12419","display_name":"Phonocardiography and Auscultation Techniques","score":0.9998999834060669,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12419","display_name":"Phonocardiography and Auscultation Techniques","score":0.9998999834060669,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11021","display_name":"ECG Monitoring and Analysis","score":0.9975000023841858,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.9584000110626221,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.6896371841430664},{"id":"https://openalex.org/keywords/deep-learning","display_name":"Deep learning","score":0.5095143914222717},{"id":"https://openalex.org/keywords/artificial-intelligence","display_name":"Artificial intelligence","score":0.49510064721107483},{"id":"https://openalex.org/keywords/speech-recognition","display_name":"Speech recognition","score":0.4919109344482422},{"id":"https://openalex.org/keywords/heart-sounds","display_name":"Heart sounds","score":0.4535438120365143},{"id":"https://openalex.org/keywords/cardiology","display_name":"Cardiology","score":0.11428561806678772},{"id":"https://openalex.org/keywords/medicine","display_name":"Medicine","score":0.10285016894340515}],"concepts":[{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.6896371841430664},{"id":"https://openalex.org/C108583219","wikidata":"https://www.wikidata.org/wiki/Q197536","display_name":"Deep learning","level":2,"score":0.5095143914222717},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.49510064721107483},{"id":"https://openalex.org/C28490314","wikidata":"https://www.wikidata.org/wiki/Q189436","display_name":"Speech recognition","level":1,"score":0.4919109344482422},{"id":"https://openalex.org/C2779435589","wikidata":"https://www.wikidata.org/wiki/Q967103","display_name":"Heart sounds","level":2,"score":0.4535438120365143},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.11428561806678772},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.10285016894340515}],"mesh":[{"descriptor_ui":"D000077321","descriptor_name":"Deep Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000077321","descriptor_name":"Deep Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000077321","descriptor_name":"Deep Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000465","descriptor_name":"Algorithms","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000465","descriptor_name":"Algorithms","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000465","descriptor_name":"Algorithms","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D004562","descriptor_name":"Electrocardiography","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D004562","descriptor_name":"Electrocardiography","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D004562","descriptor_name":"Electrocardiography","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D006347","descriptor_name":"Heart Sounds","qualifier_ui":"Q000502","qualifier_name":"physiology","is_major_topic":true},{"descriptor_ui":"D006347","descriptor_name":"Heart Sounds","qualifier_ui":"Q000502","qualifier_name":"physiology","is_major_topic":true},{"descriptor_ui":"D006347","descriptor_name":"Heart Sounds","qualifier_ui":"Q000502","qualifier_name":"physiology","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012372","descriptor_name":"ROC Curve","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012372","descriptor_name":"ROC Curve","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012815","descriptor_name":"Signal Processing, Computer-Assisted","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012815","descriptor_name":"Signal Processing, Computer-Assisted","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012815","descriptor_name":"Signal Processing, Computer-Assisted","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D016571","descriptor_name":"Neural Networks, Computer","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D016571","descriptor_name":"Neural Networks, Computer","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D016571","descriptor_name":"Neural Networks, Computer","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1109/embc53108.2024.10782371","is_oa":false,"landing_page_url":"https://doi.org/10.1109/embc53108.2024.10782371","pdf_url":null,"source":null,"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"2024 46th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)","raw_type":"proceedings-article"},{"id":"pmid:40039014","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/40039014","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference","raw_type":null}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Quality Education","id":"https://metadata.un.org/sdg/4","score":0.5}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":12,"referenced_works":["https://openalex.org/W2020459286","https://openalex.org/W2653848517","https://openalex.org/W2962858109","https://openalex.org/W3005067038","https://openalex.org/W3132952621","https://openalex.org/W3157787873","https://openalex.org/W3165504692","https://openalex.org/W4284712117","https://openalex.org/W4315433391","https://openalex.org/W4316041223","https://openalex.org/W4390446851","https://openalex.org/W6734269609"],"related_works":["https://openalex.org/W2731899572","https://openalex.org/W3215138031","https://openalex.org/W3009238340","https://openalex.org/W4360585206","https://openalex.org/W4321369474","https://openalex.org/W4285208911","https://openalex.org/W3082895349","https://openalex.org/W4213079790","https://openalex.org/W2248239756","https://openalex.org/W3086377361"],"abstract_inverted_index":{"We":[0],"introduce":[1],"a":[2,31,41,75,81,101,123,136],"Gradient-weighted":[3],"Class":[4],"Activation":[5],"Mapping":[6],"(Grad-CAM)":[7],"methodology":[8],"to":[9,49,99,129,148],"assess":[10],"the":[11,63,91,119,130,145,153,159,166,182,190],"performance":[12,82],"of":[13,21,94,111,158,189],"five":[14],"distinct":[15],"models":[16,29,57,146,183],"for":[17,90,174],"binary":[18],"classification":[19,93],"(normal/abnormal)":[20],"synchronized":[22],"heart":[23],"sounds":[24,170],"and":[25,51,54,74,115,156,172],"electrocardiograms.":[26],"The":[27,78],"applied":[28,47],"comprise":[30],"one-dimensional":[32],"convolutional":[33,43],"neural":[34,44],"network":[35,45],"(1D-CNN)":[36],"using":[37,85,100],"solely":[38],"ECG":[39,52,105,120,160],"signals,":[40,53,96],"two-dimensional":[42],"(2D-CNN)":[46],"separately":[48],"PCG":[50,102,168],"two":[55,68,167],"multimodal":[56,64],"that":[58,144,181],"employ":[59],"both":[60,95],"signals.":[61],"In":[62],"models,":[65],"we":[66],"implement":[67],"fusion":[69,73,88,132],"approaches:":[70],"an":[71,86],"early":[72,87,131],"late":[76],"fusion.":[77],"results":[79],"indicate":[80],"improvement":[83],"in":[84,152],"model":[89],"joint":[92],"as":[97,162,164],"opposed":[98],"2D-CNN":[103,121],"or":[104,177],"1D-CNN":[106],"alone":[107],"(e.g.,":[108],"ROC-AUC":[109,125],"score":[110,126],"0.81":[112],"vs.":[113,140],"0.79":[114],"0.79,":[116],"respectively).":[117],"Although":[118],"demonstrates":[122],"higher":[124,150],"(0.82)":[127],"compared":[128],"model,":[133],"it":[134],"exhibits":[135],"lower":[137],"F1-score":[138],"(0.85":[139],"0.86).":[141],"Grad-CAM":[142],"unveils":[143],"tend":[147],"yield":[149],"gradients":[151],"QRS":[154],"complex":[155],"T/P-wave":[157],"signal,":[161],"well":[163],"between":[165],"fundamental":[169],"(S1":[171],"S2),":[173],"discerning":[175],"normalcy":[176],"abnormality,":[178],"thus":[179],"showcasing":[180],"focus":[184],"on":[185],"clinically":[186],"relevant":[187],"features":[188],"recorded":[191],"data.":[192]},"counts_by_year":[{"year":2025,"cited_by_count":6}],"updated_date":"2026-04-21T08:09:41.155169","created_date":"2025-10-10T00:00:00"}