Hemodynamic Determinants of the Amplitude of the First Heart Sound

Sakamoto, Tsuguya; Kusukawa, Reizo; MacCanon, D. M.; Luisada, Aldo A.

doi:10.1161/01.res.16.1.45

Cited by 93 publications

(61 citation statements)

References 27 publications

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“…However, in the performance of a stress test, the amplitude of the first heart sound varies proportionally to the changes of left ventricular contractility and is proportional to the derivative of the left ventricular pressure pulse. This result is similar to that originally obtained by Sakamoto et al (1965) in experimental animals injected with catecholamines, and is basecd on the parallel variations of amplitude of the first sound, on the one hand, and both amplitude and rapidity of left ventricular contraction, on the other, because the phonocardiogram is the third derivative of ventricular pressure or of the wall displacement Portaluppi, 1982, 1983;Luisada et al, 1973). Thus, the first sound can be considered a good index of cardiac contractility.…”

Section: S Amplitude Is Expressed As Ratio Of Initial Value (Stresssupporting

confidence: 85%

“…Blood pressure shows the balance between greater ventricular work and vascular resistance. It has been demonstrated by Sakamoto et al (1965) that the amplitude of thejrst heart sound increases in parallel with that of the j r s t derivative (dP/dt) of the left ventricular pressure, both afer catecholamines and after fluid infusion.…”

Section: First Sound Systolic Pressure and Heart Ratementioning

confidence: 99%

“…This method is based on the results of two previous studies. The first study demonstrated, in animal experiments, that injected catecholamines increased the first derivative of left ventricular pressure; the latter varied in p d e l with the amplitude of the first heart sound recoded on the chest (Sakamoto et al, 1965).…”

Section: Introductionmentioning

confidence: 99%

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Noninvasive index of cardiac contractility during stress testing: A collaborative study

Luisada

Singhal

Portaluppi

et al. 1985

Clinical Cardiology

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Summary:The present study was conducted in parallel in three different institutions with a similar purpose but using different technical setups. Based on the experimental demonstration that the external phonocardiogram is similar to the rate of acceleration (d3P/d3t) of the left ventricular pressure, and that catecholamines in a similar way i n c m the early positive wave of the left ventricular pressure and the first heart sound (S,) of the external phonocardiogram; knowing that exercise causes secretion of catecholamines and sympathetic reflexes, we have studied the S, changes as a result of exertion in 34 normal young subjects. Blood pressure, heart rate, electrocardiograph, and phonocardiograph recordings of each subject were taken. In 10 subjects, cardiac output was also recorded by impedance cardiography. The result of the study was that the first heart sound incmsed routinely 4-5 times the normal amplitude; in a few subjects the increase was up to 15 times greater. While the extent of increase of s, was proportional to the severity and duration of the effort and was usually proportional to the increase of other parameters, exceptions were noted as having marked increase of S, with moderate increase of either blood pressure or heart rate. This was explained by the different receptors activated by the catecholamines and by the complexity of hormonal and neural influences acting on various organs in a stress test. The amplitude of S, was found to be a reasonably reliable index for following changes of cardiac contractility during exercise, and the suggestion was made that this parameter should be studied in parallel with the others in routine stress tests.

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Section: S Amplitude Is Expressed As Ratio Of Initial Value (Stresssupporting

confidence: 85%

Section: First Sound Systolic Pressure and Heart Ratementioning

confidence: 99%

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Noninvasive index of cardiac contractility during stress testing: A collaborative study

Luisada

Singhal

Portaluppi

et al. 1985

Clinical Cardiology

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“…Effect of 1-norepinephrine in a dog showing a parallel increase of the early systolic wave of the first derivative (dp/dt) and the first heart sound amplitude together with an increase of left ventricular pressure (from Sakamoto et al, 1965, courtesy of the authors and Circ Res). Effect of methoxamine in a dog showing a parallel decrease of the early systolic wave of the first derivative (dp/dt) of left ventricular pressure and of the first heart sound amplitude in spite of some increase of left ventricular pressure (from Sakamoto et al, 1965, courtesy of the authors and Circ Res).…”

Section: First Sound and Sympathetic Stimulationmentioning

confidence: 99%

The first heart sound in normal and pathological conditions.

Luisada

1987

Jpn Heart J

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SUMMARYConsiderations of the physical basis of cardiac contraction and sound generation explain the mechanism of the first sound. Older theories examining this sound as the result of valve closure or stiffening are refuted.It has been demonstrated that the normal first sound originates in the left ventricle alone and that accelerations and decelerations, "timed" by mitral and aortic valves events, are its cause. Three components have been recognized in the first sound: a occurs when the left ventricular wall and septum have reached a certain tension; b when the aortic valve opens; c when the peak of the aortic pulse has been reached.The ventricular septum is an integral and essential part of the left ventricle. In left bundle branch block, abnormal activation of the septum transforms this into a passive structure resulting in a slower rise of left ventricular pressure and a longer isovolumic period. This causes a small and delayed first sound, whose components, however, are still separated by normal intervals.In right bundle branch block, the first sound has a normal amplitude and its components are separated by normal intervals.If there is a larger late component, it is a c component, similar to that of normal elderly subjects. A larger c component may also be found in atrial septal defect. The cannon sound of AV block is caused by more rapid deceleration due to higher atrial pressure at the onset of ventricular contraction resulting in intense vibrations. The first sound of arrhythmias varies in the different conditions and even in different subjects, due to the effect of several variable factors. Elevated left atrial pressure, stiffening of the mitral valve in mitral stenosis, causes a slow onset and a more rapid rise of LV pressure. This results in a delayed, but larger, first sound. The action of catecholamines on the myocardium dramatically increases the first sound. The latter

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“…The hemodynamic SonR sensor, a micro-accelerometer placed in a sealed capsule located at the tip of an atrial pacing lead, detects mechanical vibrations propagating throughout the entire heart during the cardiac cycle. The major component of the SonR signal, SonR1, is concomitant with the first heart sound [6] and has been shown to correlate with LVdP/dt_max [7]- [10]. The use of this signal for automatic optimization of AV and VV delays in CRT has been already validated [11]- [14].…”

Section: Introductionmentioning

confidence: 96%

Validation of a Marker of Atrial Contraction in the SonR Signal

Broussous¹,

Kobeissi²,

Dumont³

et al. 2015

WJCD

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Introduction: The main component of the endocardial acceleration signal (SonR) is today used for cardiac resynchronization therapy (CRT) optimization. This prospective, single center pilot study focuses on another signal component, SonR4 that may provide further information on the atrial activity. Methods and Results: SonR signal and ECG tracings were recorded simultaneously during a CRT-D optimization procedure in 15 patients (12 men, 68 ± 9.5 years, ischemic heart disease 53%) indicated for CRT. Correlation between SonR4 signal, recorded using SonR and atrial contraction, identified by Echo Doppler was evaluated by Pearson and Student's t tests under different Atrio-Ventricular (AV) delay programming. From 15 consecutive screened patients, 9 had concomitant analyzable SonR4 and ECG recordings and were included in the study population. The presence of the SonR4 component was systematically correlated to the presence of the A wave. A significant correlation was observed between SonR4 and A wave timings (r = 0.75, p = 0.02) according to different AV delays, with a high reproducibility in SonR4 assessment. Conclusion: A strong correlation between SonR4 and atrial contraction timings was observed, further suggesting that SonR4 is a marker of the atrial contraction. Additional assessments in larger populations are required to confirm these results and build further applications.

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Hemodynamic Determinants of the Amplitude of the First Heart Sound

Abstract: Control data were assigned a value of 100 in order to compensate for individual differences between animals with respect to the size and shape of the chest and body, elastic factors, and thoracic transmission characteristics.

Cited by 93 publications

References 27 publications

Noninvasive index of cardiac contractility during stress testing: A collaborative study

Noninvasive index of cardiac contractility during stress testing: A collaborative study

The first heart sound in normal and pathological conditions.

Validation of a Marker of Atrial Contraction in the SonR Signal

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