Some aspects of the left atrial sound

Bethell, Hugh; Nixon, P.G.F.

doi:10.1016/0002-8703(74)90478-5

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…The ACG-A wave is produced by outward movement of the left-ventricular apex and coincides with the peak of atrial sound [19]. The atrial sound accompanying a large ACG-A wave is considered a pathological phenomenon [19], The height of the ACG-A wave is usually estimated as the ratio to the total amplitude of the ACG; its normal upper limit is 15-20% [18].…”

Section: Amplitude Of the Acg-a Wavementioning

confidence: 99%

“…The atrial sound accompanying a large ACG-A wave is considered a pathological phenomenon [19], The height of the ACG-A wave is usually estimated as the ratio to the total amplitude of the ACG; its normal upper limit is 15-20% [18]. Concerning the correlation between the pattern of ACG and hemodynamics, in a nor mal heart, left-ventricular filling is almost complete in the early diastole,and atrial contraction does not contribute so much [20].…”

Section: Amplitude Of the Acg-a Wavementioning

confidence: 99%

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Left-Ventricular Filling Disturbances in Cardiac Amyloidosis

Hayashi¹,

Yamanaka²,

Fujinuma³

et al. 1994

Am J Noninvas Cardiol

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Cardiac amyloidosis is characterized by left-ventricular filling defects at a relatively early stage. To investigate such defects more precisely, we studied atrial sound and left-ventricular inflow velocity patterns in 12 patients with cardiac amyloidosis (mean age 60.9 ± 12.5 years). Twelve age-matched cases with hypertrophic cardiomyopathy (HCM) served as controls. We recorded the amplitude of the atrial sound by low-frequency phonocardiography and measured the height of the A wave of apexcardiogram (ACG-A wave) as well as its ratio to the total amplitude of the ACG. Using pulsed Doppler echocardiography, we measured the rapid filling wave (E) and the atrial filling wave (A) and calculated the ratio of A to E. In the amyloidosis group, the atrial sound was weaker and the ACG-A wave was significantly smaller than in the HCM group (p < 0.001; 12.4 ± 3.9 vs. 22.4 ± 5.6%). As concerns the left-ventricular inflow velocity patterns, both the E wave (41.7 ± 16.0 vs. 56.4 ± 12.1 cm/s; p < 0.02) and the A wave (40.5 ± 13.4 vs. 58.1 ± 13.0 cm/s; p < 0.006) were smaller than in the HCM group. The A/E was 1.0 ± 0.34 in the amyloidosis group and 1.1 ± 0.3 in the HCM group (NS). We conclude that disturbed left-ventricular filling, especially in the atrial filling period, decreases the amplitude of both atrial sound and ACG-A wave in cardiac amyloidosis.

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Section: Amplitude Of the Acg-a Wavementioning

confidence: 99%

Section: Amplitude Of the Acg-a Wavementioning

confidence: 99%

Left-Ventricular Filling Disturbances in Cardiac Amyloidosis

Hayashi¹,

Yamanaka²,

Fujinuma³

et al. 1994

Am J Noninvas Cardiol

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When Does a Fourth Sound Become an Atrial Gallop?

Perez¹,

Luisada²

1976

Angiology

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A study of the fourth sound was conducted on 100 normal subjects (ages 1-88 years) and 42 clinical cases with either aortic stenosis, systemic hypertension or coronary heart disease. This study was based on the graphic recognition of a presystolic sound when the tracing was taken with the use of one or more of 5 different high pass filters. Attention was paid to the existence of the fourth sound, its magnitude, and its vibrational frequency. In general it was accepted that a magnitude of 1/2 of the first heart sound or a frequency of 30 Hz denoted a pathologic fourth sound. However, exceptions were found among normal subjects, so that only the combination of the two criteria could be considered highly significant for a pathologic phenomenon (gallop). Patients with aortic stenosis presented an increase in magnitude of the fourth sound but incidence and vibrational frequency were similar to those of controls. Patients with hypertension had a greater incidence of fourth sounds, especially in middle age (100%); middle age patients usually had a greater magnitude while older patients had more often an increase in vibrational frequency. Patients with coronary heart disease (evidence of old infarcts) had an increase in the incidence, magnitude, and vibrational frequency in comparison with controls. These data and the cause of the fourth sound are discussed. The fourth sound has been repeatedly studied in the past, both as an auscultatory finding and a graphic phenomenon. Attempts were made for separating the normal fourth sound from that denoting a pathological phenomenon but, so far, no clear cut criteria for the differentiation have been obtained. We thought, therefore, that a new study was indicated.

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Some aspects of the left atrial sound

Cited by 2 publications

References 24 publications

Left-Ventricular Filling Disturbances in Cardiac Amyloidosis

Left-Ventricular Filling Disturbances in Cardiac Amyloidosis

When Does a Fourth Sound Become an Atrial Gallop?

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