Machine learning algorithms for predicting heart failure based on heart sounds captured by electronic stethoscope
 
More details
Hide details
1
Ministry of Health, Karbala Health Directorate, Al-Hindiya Sector for Primary Healthcare, Karbala, Iraq
 
2
Middle Technical University, Technical Engineering College of Artificial Intelligence, Baghdad, Iraq
 
3
Biomedical Engineering Department, Al Khwarizmi College of Engineering, University of Baghdad, Baghdad, Iraq
 
4
Middle Technical University, Kut Technical College, Wasit, Iraq
 
5
Middle Technical University, Technical Institute / Kut, Wasit, Iraq
 
 
Submission date: 2026-03-18
 
 
Final revision date: 2026-07-29
 
 
Acceptance date: 2026-08-23
 
 
Online publication date: 2026-09-01
 
 
Publication date: 2026-09-01
 
 
Corresponding author
Ali Hussein Shaker   

Ministry of Health, Karbala Health Directorate, Al-Hindiya Sector for Primary Healthcare, Karbala, Iraq
 
 
 
KEYWORDS
TOPICS
ABSTRACT
Heart failure is a critical medical illness that can be deadly if not diagnosed or predicted in time, as it results from the heart's inability to pump enough blood throughout the body. Traditional diagnostic tools such as electrocardiograms, phonocardiograms, and stethoscopes have been inadequate for early detection of heart failure. This study leveraged recorded heart-sound data from an electronic stethoscope, converting it into NumPy arrays using Mel-Frequency Cepstral Coefficients to predict heart failure using machine learning (ML) algorithms. The study utilized four ML algorithms: Random Forest (RF), Support Vector Machine (SVM), Gradient Boosting (GB), and Extreme Gradient Boosting (XGBoost). The dataset, comprising 13 MFCC-derived audio features for 300 subjects, was split into 80% for training and 20% for testing using 10-fold cross-validation. The ML models' performance was assessed using accuracy, sensitivity, precision, specificity, F1-score, precision-recall curve, and Area Under the Curve (AUC) to identify the most accurate model. SVM and XGBoost emerged as the most accurate models in the testing set, achieving 100% accuracy across all metrics and the highest AUCs of 100% for RF, SVM, and XGBoost. Based on heart sound data and ML models, the proposed study has demonstrated superior predictive performance for HF compared with previous studies
FUNDING
This research received no external funding.
REFERENCES (42)
1.
Chicco D, Jurman G. Machine learning can predict survival of patients with heart failure from serum creatinine and ejection fraction alone. BMC Med Inform Decis Mak. 2020;20(1):16. https://doi.org/10.1186/s12911....
 
2.
Ma LY, Chen WW, Gao RL, Liu LS, Zhu ML, Wang JY, Wu ZS, Li HJ, Gu DF, Yang YJ, Zheng Z, Hu SS. China cardiovascular diseases report 2018: an updated summary. J Geriatr Cardiol. 2020;17(1):1-8. http://doi.org/10.11909/j.issn....
 
3.
Gevaert AB, Kataria R, Zannad F, Sauer AJ, Damman K, Sharma K, Shah SJ, Van Spall HGC. Heart failure with preserved ejection fraction: recent concepts in diagnosis, mechanisms and management. Heart. 2022; 108(17):1342-1350. http://doi.org/10.1136/heartjn....
 
4.
Nauta JF, Hummel JM, van der Meer P, Lam CSP, Voors AA, van Melle JP. Correlation with invasive left ventricular filling pressures and prognostic relevance of the echocardiographic diastolic parameters used in the 2016 ESC heart failure guidelines and in the 2016 ASE/EACVI recommendations: a systematic review in patients with heart failure with preserved ejection fraction. Eur J Heart Fail. 2018;20(9):303-1311. http://doi.org/10.1002/ejhf.12....
 
5.
Mueller C, McDonald K, de Boer RA, Maisel A, Cleland JGF, Kozhuharov N, Coats AJS, Metra M, Mebazaa A, Ruschitzka F, Lainscak M, Filippatos G, Seferovic PM, Meijers WC, Bayes-Genis A, Mueller T, Richards M, Januzzi Jr JL. Heart Failure Association of the European Society of, "Heart Failure Association of the European Society of Cardiology practical guidance on the use of natriuretic peptide concentrations. Eur J Heart Fail. 2019;21(6):715-731. http://doi.org/10.1002/ejhf.14....
 
6.
Kusunose K, Haga A, Abe T, Sata M. Utilization of artificial intelligence in echocardiography. Circ J. 2019;83(8):1623-1629. http://doi.org/10.1253/circj.C....
 
7.
Alsharqi M, Woodward WJ, Mumith JA, Markham DC, Upton R, Leeson P. Artificial intelligence and echocardiography. Echo Res Pract. 2018;5(4):R115-R125. http://doi.org/10.1530/ERP-18-....
 
8.
Goto S, Mahara K, Beussink-Nelson L, Ikura H, Katsumata Y, Endo J, Gaggin KH, Shah SJ, Itabashi Y, MacRae CA, Deo RC. Artificial intelligence-enabled fully automated detection of cardiac amyloidosis using electrocardiograms and echocardiograms. Nat Commun. 2021;12(1):2726. http://doi.org/10.1038/s41467-....
 
9.
Li F, Zhang Z, Wang L, Liu W. Heart sound classification based on improved mel-frequency spectral coefficients and deep residual learning. Front Physiol. 2022;13:1084420. http://doi.org/10.3389/fphys.2....
 
10.
Li F, Tang H, Shang S, Mathiak K, Cong F. Classification of heart sounds using convolutional neural network. Applied Sciences. 2020;10(1). http://doi.org/10.3390/app1011....
 
11.
Taylor CJ, Ordonez-Mena JM, Roalfe AK, Lay-Flurrie S, Jones NR, Marshall T, Hobbs FDR. Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study. BMJ. 2019;364:1223. http://doi.org/10.1136/bmj.l22....
 
12.
Tse G, Zhou J, Woo SWD, Ko CH, Lai RWC, Liu T, Liu T, Leung KSK, Li A, Lee S, Li KHC, Lakhani I, Zhang Q, Multi-modality machine learning approach for risk stratification in heart failure with left ventricular ejection fraction http://doi.org/10.1002/ehf2.12....
 
13.
Chowdhury MEH, Khandakar A, Alzoubi K, Mansoor S, Tahir AM, Reaz MBI, Al-Emadi N. Real-time smart-digital stethoscope system for heart diseases monitoring. Sensors (Basel). 2019;19(12):2781. http://doi.org/10.3390/s191227....
 
14.
Omarov B, Saparkhojayev N, Shekerbekova S, Akhmetova O, Sakypbekova M, Kamalova G, Alimzhanova Z, Tukenova L, Akanova Z. Artificial intelligence in medicine: real time electronic stethoscope for heart diseases detection. Computers, Materials & Continua. 2022;70(2):2815-2833. http://doi.org/10.32604/cmc.20....
 
15.
Zeinali Y, Niaki STA. Heart sound classification using signal processing and machine learning algorithms. Machine Learning with Applications. 2022;7. http://doi.org/10.1016/j.mlwa.....
 
16.
Ali SN, Shuvo SB, Al-Manzo MIS, Hasan A, Hasan T. An end-to-end deep learning framework for real-time denoising of heart sounds for cardiac disease detection in unseen noise. IEEE Access. 2023;11: 87887-87901. http://doi.org/10.1109/access. 2023.3292551.
 
17.
Sinha Roy T, Roy JK, Mandal N. Conv-random forest-based IoT: A deep learning model based on CNN and random forest for classification and analysis of valvular heart diseases. IEEE Open Journal of Instrumentation and Measurement. 2023;2:1-17. http://doi.org/10.1109/ojim.20....
 
18.
Nishitha MK, Chittesh M. Perception of heart failures from heart sounds using neural networks. Journal of Engineering Sciences. 2023;14(07):769-780.
 
19.
Alrabie S, Barnawi A. HeartWave: A multiclass dataset of heart sounds for cardiovascular diseases detection. IEEE Access. 2023;11:118722-118736. http://doi.org/10.1109/access. 2023.3325749.
 
20.
Deng M, Meng T, Cao J, Wang S, Zhang J, Fan H. Heart sound classification based on improved MFCC features and convolutional recurrent neural networks. Neural Networks. 2020;130:22-32. http://doi.org/10.1016/j.neune....
 
21.
Kui H, Pan J, Zong R, Yang H, Wang W. Heart sound classification based on log Mel-frequency spectral coefficients features and convolutional neural networks. Biomedical Signal Processing and Control. 2021;69:102893. https://doi.org/10.1016/j.bspc....
 
22.
Najjar R. Redefining radiology: a review of artificial intelligence integration in medical imaging. Diagnostics. 2023;13(17):2760, 2023. https://doi.org/10.3390/diagno....
 
23.
Myszczynska MA, Ojamies PN, Lacoste AM, Neil D, Saffari A, Mead R, Hautbergue GM, Holbrook JD, Ferraiuolo L. Applications of machine learning to diagnosis and treatment of neurodegenerative diseases. Nature Reviews Neurology. 2020;16(8): 440-456. https://doi.org/10.1038/s41582....
 
24.
Kutluyarov RV, Zakoyan AG, Voronkov GS, Grakhova EP, Butt MA. Neuromorphic photonics circuits: contemporary review. Nanomaterials. 2023; 13(24):3139. https://doi.org/10.3390/nano13....
 
25.
Asaad Yaseen G, Gharghan SK, Mutlag AHM, Rosdiadee N. Wireless sensor network-based artificial intelligent irrigation system: Challenges and limitations. Journal of Techniques. 2023;5(3):26-41. http://doi.org/10.51173/jt.v5i....
 
26.
Zeini HA, Al-Jeznawi D, Imran H, BernardoLFA, Al-Khafaji Z, Ostrowski KA. Random forest algorithm for the strength prediction of geopolymer stabilized clayey soil. Sustainability. 2023;15(2):1408. http://doi.org/10.3390/su15021....
 
27.
Khozeimeh F, Sharifrazi D, Izadi NH, Joloudari JH, Shoeibi A, Alizadehsani R, Tartibi M, Hussain S, Sani ZA, Khodatars M, Sadeghi D, Khosravi A, Nahavandi S, Tan RS, Acharya UR, Islam SMS. RF-CNN-F: random forest with convolutional neural network features for coronary artery disease diagnosis based on cardiac magnetic resonance. Scientific Reports. 2022; 12(1):11178. http://doi.org/10.1038/s41598-....
 
28.
Golpour P, Ghayour-Mobarhan M, Saki A, Esmaily H, Taghipour A, Tajfard M, Ghazizadeh H, Moohebati M, Ferns GA. Comparison of support vector machine, naive bayes and logistic regression for assessing the necessity for coronary angiography. International Journal of Environmental Research and Public Health. 2020;17(18):6449. http://doi.org/10.3390/ijerph1....
 
29.
Elsedimy EI, AboHashish SMM, Algarni F. New cardiovascular disease prediction approach using support vector machine and quantum-behaved particle swarm optimization. Multimedia Tools and Applications. 2023;83(8):23901-23928. http://doi.org/10.1007/s11042-....
 
30.
Ruiz-Gonzalez R, Gomez-Gil J, Gomez-Gil FJ, Martinez-Martinez V. An SVM-based classifier for estimating the state of various rotating components in agro-industrial machinery with a vibration signal acquired from a single point on the machine chassis. Sensors (Basel). 2014;14(11):20713-35. http://doi.org/10.3390/s141120....
 
31.
Chandrasekhar N, Peddakrishna S. Enhancing heart disease prediction accuracy through machine learning techniques and optimization. Processes. 2023;11(4).http://doi.org/10.3390/pr11041....
 
32.
Bentéjac C, Csörgő A, Martínez-Muñoz G. A comparative analysis of gradient boosting algorithms. Artificial Intelligence Review. 2020;54(3):1937-1967. http://doi.org/10.1007/s10462-....
 
33.
Budholiya K, Shrivastava SK, Sharma V. An optimized XGBoost based diagnostic system for effective prediction of heart disease. Journal of King Saud University - Computer and Information Sciences. 2022;34(7):4514-4523. http://doi.org/10.1016/j.jksuc....
 
34.
Bhatt CM, Patel P, Ghetia T, Mazzeo PL. Effective heart disease prediction using machine learning techniques. Algorithms. 2023;16(2). http://doi.org/10.3390/a160200....
 
35.
Sahin EK Comparative analysis of gradient boosting algorithms for landslide susceptibility mapping. Geocarto International. 2020;37(9):2441-2465. http://doi.org/10.1080/1010604....
 
36.
Aldelemy A, Abd-Alhameed RA. Binary classification of customer’s online purchasing behavior using machine learning. Journal of Techniques. 2023;5(2):163-186. http://doi.org/10.51173/jt.v5i....
 
37.
Ozcan M, Peker S. A classification and regression tree algorithm for heart disease modeling and prediction. Healthcare Analytics. 2023;3. http://doi.org/10.1016/j.healt....
 
38.
Shuvo SB, Ali SN, Swapnil SI, Al-Rakhami MS, Gumaei A. CardioXNet: A novel lightweight deep learning framework for cardiovascular disease classification using heart sound recordings. IEEE Access. 2021;9:36955-36967. http://doi.org/10.1109/access. 2021.3063129.
 
39.
Zhou X, Wang X, Li X, Zhang Y, Liu Y, Wang J, Chen S, Wu Y, Du B, Wang X, Sun X, Sun K. A novel 1-D densely connected feature selection convolutional neural network for heart sounds classification. Annals of Translational Medicine. 2021;9(24):1752. http://doi.org/10.21037/atm-21....
 
40.
Alshboul O, Shehadeh A, Almasabha G, Almuflih AS. Extreme gradient boosting-based machine learning approach for green building cost prediction. Sustainability. 2022;14(11). http://doi.org/10.3390/su14116....
 
41.
Saeedbakhsh S, Sattari M, Mohammadi M, Najafian J, Mohammadi F. Diagnosis of coronary artery disease based on machine learning algorithms support vector machine, artificial neural network, and random forest. Advanced Biomedical Research. 2023;12:51. http://doi.org/10.4103/abr.abr....
 
42.
Kalimuthu M, Hemanth C. Preliminary study on real-time phonocardiogram signal acquisition and analysis using machine learning and IoMT for digital stethoscope. 2025;13:68682-68709. http://doi.org/10.1109/ACCESS.....
 
eISSN:2449-5220
Journals System - logo
Scroll to top