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At least 19 recordsLinked to original sources
PubMed1992

Implications of third heart sounds in patients with valvular heart disease. The Veterans Affairs Cooperative Study on Valvular Heart Disease.

BACKGROUND: The presence of third heart sounds in patients with valvular heart disease is often regarded as a sign of heart failure, but it may also depend on the type of valvular disease. METHODS: We assessed the prevalence of third heart sounds and the relation between third heart sounds and cardiac function in 1281 patients with six types of valvular heart disease. RESULTS: The prevalence of third heart sounds was higher in patients with mitral regurgitation (46 percent) or aortic regurgitation (28 percent) than in those with aortic stenosis (11 percent) or mitral stenosis (8 percent). The left ventricular ejection fraction was significantly lower (P less than 0.001) when a third heart sound was detected in patients with aortic stenosis (0.38, vs. 0.56 in those without third heart sounds) or mixed aortic valve disease (0.40 vs. 0.55). However, the ejection fraction was only slightly lower in patients with mitral regurgitation and third heart sounds (0.51 vs. 0.57, P = 0.03). The pulmonary-capillary wedge pressure was higher (P less than 0.001) when a third heart sound was detected in patients with aortic stenosis (18.6 mm Hg, vs. 12.1 mm Hg in those without third heart sounds). There was no association between the wedge pressure and third heart sounds in patients with mitral regurgitation. The prevalence of third heart sounds increased with the severity of mitral regurgitation. CONCLUSIONS: In patients with mitral regurgitation, third heart sounds are common but do not necessarily reflect left ventricular systolic dysfunction or increased filling pressure. In patients with aortic stenosis, third heart sounds are uncommon but usually indicate the presence of systolic dysfunction and elevated filling pressure.

Adult↗
PubMed1992

[Heart sounds--a mathematical transformation of blood pressure? On the origin of heart sounds].

Two main theories exist concerning the origin of the heart sounds. The first proposes that rapid pressure fluctuations cause the cardiac valve leaflets to vibrate and produce the sound. The second theory suggests that sudden pressure perturbations cause the entire cardiohemic mass to vibrate as a whole. In 35 patients (26 men and 9 women, aged 18 to 73) with various heart diseases microtransducer catheters (Millar) were used to simultaneously record aortic pressures and aortic internal phonocardiograms in order to determine if they had a common mode of origin and propagation. The propagation velocities of the first heart sound and the foot of the aortic pressure pulse were found to be similar, 5.24 +/- 0.61 m/s and 5.97 +/- 1.87 m/s respectively (+/- SE). It was possible to derive facsimiles of the aortic internal phonocardiogram by double differentiation of the corresponding aortic pressure pulse and conversely to derive the pressure pulse by double integration of the phonocardiogram. These data support the concept that the low-frequency pressure variations produced by the entire cardiohemic mass, which predominate in the aortic pressure pulse waveforms, are generated and propagated in the same manner as the high-frequency pressure variations, which are the first and second heart sounds.

Adolescent↗
PubMed1977

[Contoursonagraphic analysis of heart sound phenomena and sounds produced by various heart valve prostheses].

The normal heart sounds, murmurs, opening and closing sounds of aortic and mitral valve prostheses were recorded on a tape and analyzed in terms of contour sonagrams in order to obtain the highest frequencies which were recordable on the chest wall. The peak frequencies showed a broad range, the maximum beeing reached at about 8000 c.p.s. in the case of the sounds of prosthetic valves. Furthermore, sound level examinations of the normal first and second heart sound, as well as of the opening and closing sounds of the aortic valve prostheses were performed. The highest sound level of all of these sounds was found to lie within the low frequency range of 40 to 100 c.p.s.

Aortic Valve Insufficiency↗
PubMed1976

[Sound spectrographic investigations of heart sounds and murmurs and of the sounds produced by artificial valves (author's transl)].

The normal heart sounds, murmurs, opening and closing sounds of aortic and mitral valve prostheses were recorded on a tape in order to obtain the highest frequencies which were recordable on the chest wall. Sections of these tapes were analyzed in terms of contour sonagrams. For this purpose six groups were formed and investigated: group I comprised persons without cardiovascular diseases, group II patients with mitral valve failure, group III patients with aortic valve failure, group IV patients with congenital heart disease, group V patients with Starr-Edwards aortic valve prostheses (model 1260) and group VI patients with various mitral valve prostheses. In each of these groups the highest recordable frequencies were measured. The peak frequencies varied widely in regard to frequency range in a comparison of the six groups. The maximum was reached at about 8000 c.p.s. in the case of the sounds of prosthetic valves. Furthermore, sound level examinations of the normal first and second heart sounds, as well as of the opening and closing sounds of the aortic valve prostheses were performed. The highest sound level of all of these sounds was found to lie within the low frequency range of 40 to 100 c.p.s. The results of both the measurements of the peak frequencies and of the maximal sound level were discussed on the basis of the presently accepted theories on the mechanism of heart sounds and murmurs.

Aortic Valve↗
PubMed1979

Echocardiography and fetal heart sounds in the diagnosis of fetal heart block.

A 32-week fetus was demonstrated phonocardiographically and echocardiographically to have a regular atrial rate of 150 per minute and a regular ventricular rate of 39 per minute, indicating complete heart block. The diagnosis was suspected when two groups of heart sounds at two distinct rates were heard on auscultation, and was confirmed by the postnatal ECG. The maternal history was significant for the presence of systemic lupus erythematosus. The basis for the echocardiographic diatnosis of complete heart block, the presence of atrial heart sounds in complete heart block, and the relationship of maternal SLE to congenital heart block are discussed.

Adult↗
PubMed1978

A phonocardiographic study of equine heart sounds.

The occurrence and timing of heart sounds were examined from phonocardiograms taken from the mitral, aortic and tricupsid recording areas in each of 18 horses. 10 sound events could be identified with each cardiac cycle. Atrial contraction produced up to 3 sound events. The first heart sound consisted of 4 components whereas the second sound was single. Two sound events were associated with the 3rd heart sound in early diastole. The occurrence of third and fourth heart sound components varied between horses and between recording areas. The mitral recording area was considered most satisfactory for routine phonocardiographic studies in horses.

Animals↗
PubMed1979

The first heart sound abnormalities accompanied with alteration of systolic time intervals in incipient heart failure.

A phonocardiological analysis of the first heart sound was made and systolic time intervals were measured in 40 patients (ischaemic heart disease, hypertensive heart disease, cardiomyopathies) with incipient cardiac failure (functional groups I--II according to the NYHA) with auscultatory changes of the first heart sound and in controls of randomly selected healthy persons or patients in whom cardiopulmonary disease was excluded. The patients in all diagnostic groups differed significantly (P less than 0.05--0.001) in practically all the phonocardiographic indicators from the controls. The most constant abnormal finding was a pathological split of the first heart sound which may be divided into three phonocardiographic forms. Simultaneously, systolic time intervals alterations (P less than 0.02--0.001) were also found in these patients and indicated a lowered performance of the left ventricle. The results suggest that 1) a certain relation exists between systolic time intervals and the phonocardiographic pattern of the first heart sound in patients with cardiovascular diseases and those without it; 2) the modified (pathologically splitted and prolonged) first heart sound could be a sign of incipient cardiac failure.

Cardiovascular Diseases↗
PubMed1977

The fourth heart sound in patients without demonstrable heart disease.

One hundred patients, 17 to 67 years of age, had normal hearts diagnosed on the basis of complete right and left heart catheterization and coronary cineangiography. Phonocardiograms were obtained from each patient, providing an average of 17 recordings per subject for analysis; 75/100 (75%) subjects had a recordable fourth sound; 60/75 (80%) of the latter group had an audible fourth heart sound. It is concluded that recordable and audible fourth heart sounds are common findings in subjects without catheterization evidence of cardiovascular disease.

Adolescent↗
PubMed1979

Study of respiratory influence on the intensity of heart sound in normal subjects.

The amplitudes of the first and second heart sounds were recorded during quiet natural breathing in 31 normal subjects. A total of 3,656 and 3,016 heart beats were available at the apex and pulmonic areas respectively. The intensities of the first and second heart sounds were found to be increased during expiration. This respiratory tendency in the heart sounds was less prominent during the transitional phase between expiration and inspiration. Therefore we suggest that respiratory changes in heart sounds should be evaluated with a heart beat located at or close to the center of each inspiration and expiration. Respiratory alteration in the intensity of heart sounds is one of the commonest auscultatory pitfalls. Auscultatory evaluation of the intensity of heart sounds should thus be performed carefully, with the respiratory changes kept in mind.

Adolescent↗
PubMed1977

Recording of the fourth heart sound by the signal averaging method. Preliminary report.

The fourth heart sound was clearly recorded by using the signal averaging method. Furthermore, the simultaneous recording of the Doppler signal with the fourth heart sound was performed. Thus, it was demonstrated that the Doppler signal started after the P wave and followed by the fourth heart sound. In 2 cases, the effect of the double Master's test and taking a bath was studied on the computer averaged phonocardiogram. After the exercise, the amplitude of the fourth heart sound was increased, whereas after taking a bath it was almost unchanged. The above results show that the simultaneous recordings of a computer averaged phonocardiogram and Doppler signal that is associated with cardiac activity can greatly facilitate the interpretation of small vibrations such as the fourth heart sound.

Activities of Daily Living↗
PubMed1992

A new heart-sounds gating device for medical imaging.

A heart-sounds gating device has been designed and tested which identifies, individually, both the first (S1) and second (S2) heart sound from their timing relationship, providing two trigger points through the cardiac cycle for synchronizing medical images. The new heart-sounds gate utilizes dynamically varying timing windows to anticipate the occurrence of S1 and S2. The heart-sounds gate has been initially applied to nuclear imaging of the cardiac bloodpool, but may be applied to any imaging modality requiring cardiac synchronization.

Electrocardiography↗
PubMed1992

Non-invasive determination of systolic blood pressure by heart sound pattern analysis.

A new concept of non-invasive blood pressure measurement by heart sound pattern analysis is described. The known diagnostic criterion of the 'accentuated' second heart sound of a hypertensive patient is here converted into a computer-aided pattern-recognition process for the second heart sound, applicable over the entire scale of blood pressure. After a 'learning phase', during which the second heart sound is recorded, analysed and correlated with a set of systolic blood pressure values of the individual patient, the computer is able to determine systolic blood pressure of the same patient from the acoustic spectrum of the second heart sound with sufficient precision. The method is in principle suited for automatically repeated blood pressure measurements, but further development is still needed for conversion into a widely practicable procedure.

Blood Pressure↗
PubMed1977

The study of the third heart sound in relation to the left ventricular filling and wall movement by echocardiography.

The left ventricular filling and wall movement were investigated in subjects with a third heart sound or ventricular gallop by echocardiography. Nine patients with ventricular gallop, who had left ventricular volume overload disease, and 6 normal subjects with a third heart sound had higher normalized peak rate of increase of the left ventricular dimension (peak dD/dT/D) than 10 normal subjects without a third heart sound (p less than 0.01). The normalized lengthening rate in the rapid filling phase was also higher in patients with ventricular gallop than in normal subjects without a third heart sound (p less than 0.05). The time from the second heart sound to peak dD/dT/D and rapid filling time did not show statistically significant values between subjects with ventricular gallop or a third heart sound and those without a third heart sound. These results suggest that higher peak filling, larger filling volume in the rapid filling phase and more abrupt cessation of the outward movement of the left ventricular wall may be a cause of the production of ventricular gallop in patients with left ventricular volume overload and of the physiological third heart sound.

Adolescent↗