# Classification of Valvular Regurgitation Using Echocardiography
###### Abstract  
Echocardiography (echo) is a commonly utilized tool in the diagnosis of various forms of valvular heart disease for its ability to detect types of cardiac regurgitation. Regurgitation represents irregularities in cardiac function and the early detection of regurgitation is necessary to avoid invasive cardiovascular surgery. In this paper, we focussed on the classification of regurgitations from videographic echo images. Three different types of regurgitation are considered in this work, namely, aortic regurgitation (AR), mitral regurgitation (MR), and tricuspid regurgitation (TR). From the echo images, texture features are extracted, and classification is performed using Random Forest (RF) classifier. Extraction of keyframe is performed from the video file using two approaches: a reference frame keyframe extraction technique and a redundant frame removal technique. To check the robustness of the model, we have considered both segmented and nonsegmented frames. Segmentation is carried out after keyframe extraction using the Level Set (LS) with Fuzzy C-means (FCM) approach. Performances are evaluated in terms of accuracy, precision, recall, and F1-score and compared for both reference frame and redundant frame extraction techniques. K-fold cross-validation is used to examine the performance of the model. The performance result shows that our proposed approach outperforms other state-of-art machine learning approaches in terms of accuracy, precision, recall, and F1-score. videographic echo; regurgitation; level set; random forest Article Classification of Valvular Regurgitation Using Echocardiography  
[1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19] [20] [21] [22] [23] [24] [25] [26] [27] [28] [29] [30] [31] [32] [33] [34] [35] [36] [37] [38] [39] [40] [41] [42] [43] [44] [is leakage caused in the heart valves, which is caused by incorrect closing of the leaflets where blood flows back, or blood leaks through. It can be congenital or acquired. Acquired cases are mainly caused due to smoking, tobacco consumption, lack of exercise, and others. Aortic regurgitation (AR), mitral regurgitation (MR), and tricuspid regurgitation (TR) are the three most common types of regurgitation, which are shown in Figure 1. When it comes to rheumatic heart disorders and youngsters, MR is the most frequent valvular involvement [5]. It is the most typical type of heart valve disease. In MR, the valve between the left heart chambers does not completely close, which causes blood to leak backward across the valve. It is known that AR occurs less frequently than MR. The disease of the aortic leaflets or the aortic root causes the leaflets to distort and hinder their proper apposition, which causes AR, for which careful analysis of the aortic valve is necessary. Rheumatic fever, bicuspid aortic valve, infective endocarditis, and senile leaflet calcifications are common causes of leaflet abnormalities that lead to AR [6]. TR, on the other hand, is a condition where the valve between the right ventricle and right atrium does not close completely. Blood leaks backward into the upper right chamber as a result [6]. These data are obtained using the transthoracic procedure in the left lateral decubitus [7]. The data are 3D color Doppler videographic images. Using color Doppler, regurgitation can be identified based on the color jets characteristics. Other abnormalities, such as aortic stenosis (AS), mitral stenosis (MS), and tricuspid stenosis (TS), and other cardiovascular disorders, can be distinguished from regurgitation [8]. Echo can be used to access, detect, and diagnose regurgitation at an early stage. Regurgitation can range from mild to severe. Mild and moderate regurgitation can usually be treated without surgery; however, severe regurgitation may require surgery or cauterization [9]. For most of the population, especially in developing and rural economies, this procedure is expensive and unaffordable [10].