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Pulsed Doppler evaluation of left ventricular filling in subjects with pathologic and physiologic third heart sound

, : Pulsed Doppler evaluation of left ventricular filling in subjects with pathologic and physiologic third heart sound. European Heart Journal 11(6): 500-508

Haemodynamic studies suggest that the rapid deceleration of left ventricular inflow at the end of early diastole may play an important role in the genesis of the third heart sound (S3). To confirm this hypothesis noninvasively, pulsed Doppler of transmitral flow was used. Mitral flow velocity wave was recorded in 20 post-infarction patients with audible S3 (Group I), in 20 young healthy individuals wtih physiologic S3 (Group II), in 20 postinfarction patients within S3 (Group III) and in 20 normal adults (Group IV). Peak flow velocity in early diastole (Ev), peak flow velocity during atrial systole (Av), the Ev/Av ratio, the deceleration of early diastolic flow (EF slope), the ratio of the time velocity integral of early diastole to the total time velocity integral (TVle/TVlt) and the isovolumic relaxation time (IVRT) were measured from Doppler recordings. The time relation between S3, the mitral valve motion on M-mode tracing, and the mitral flow velocity wave were analysed comparing the intervals from the second sound to Ev (A2-Ev), to the E point of mitral valve motion (A2-Em) and to the S3 (A2-S3). In groups I and II Ev/Av ratio was higher (respectively 4.4 .+-. 2.2 and 2.8 .+-. 1.1) than in group III (0.8 .+-. 0.4) and IV (1.3 .+-. 0.3). Similar results were found for the TVle/TVlt ratio. In both groups with S3, EF slope was significantly steeper (respectively 9 .+-. 1.8 and 7.5 .+-. 1.1 ms) than in normal adults (4.4 .+-. 1.1 ms) and patients without S3 (3.6 .+-. 1.1 ms). The IVRT in S3 groups was shorter than in group III and IV. In all subjects, S3 was synchronous with Ev point and persisted during the EF slope. In fact A2-Ev and A2-S3 were almost equal (133 .+-. 15 vs 134 .+-. 15). In conclusion our data support the concept that, whatever the underlying haemodynamic conditions, the genesis of S3 is related to an enhanced early filling phase followed by a rapid halting of inflow.


PMID: 2351159

Other references

Baer H.H.; Bell A.J., 1979: The synthesis of 3 amino 3 deoxy alpha d gluco pyranosyl alpha d gluco pyranoside 3 amino 3 deoxy alpha alpha trehalose. Carbohydrate Research 75: 175-184

Aronow, W.S.; Ahn, C.; Mercando, A.D.; Epstein, S.; Kronzon, I., 1994: Effect of propranolol versus no antiarrhythmic drug on sudden cardiac death, total cardiac death, and total death in patients > or = 62 years of age with heart disease, complex ventricular arrhythmias, and left ventricular ejection fraction > or = 40%. American Journal of Cardiology 74(3): 267-270

Kafas, P.; Kalfas, S., 2008: Carbonization of a radicular cyst using fiber-optic diode laser: a case report. A female patient, 51 years old, complaint of painful swelling on the anatomical area of the upper left lateral incisor. The diagnosis of radicular cyst was confirmed histo-pathologically. Nowadays, radicular cysts may be treated using conventiona...

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Passik, S.D., 1994: Psycho-oncology V: Psychosocial factors in cancer risk and survival. Memorial Sloan Kettering Cancer center, New York City, New York, 2-4 October 1993. Supportive Care in Cancer 2(2): 136-138

Katoh, M.; Kamiyama, H.; Kobayashi, N.; Makino, K.; Takano, K.; Tokumitsu, N.; Takamura, H., 1999: Severe stenosis of the internal carotid artery presenting as loss of consciousness due to the presence of a primitive hypoglossal artery: A case report. Background Symptoms of ischemic attacks in the internal carotid system usually involve focal cerebral dysfunction, i.e., hemiparesis or aphasia. However, an ischemic attack in the vertebrobasilar artery system usually presents with combined sympto...

Miglets, A.W., 1971: Prevention of tracheal graft stenosis with steroids. Archives of Otolaryngology 93(5): 492-495

Murata H., 1980: Experimental lung lesion in mice by intra venous administration of soluble immune complexes. Soluble immune complexes consisting of rabbit antibody to bovine serum albumin (BSA) were made up at 5-fold and 20-fold antigen excess. Preformed 5-fold antigen excess BSA anti-BSA immune complexes were given twice i.v. to C57BL/6 mice at an inter...

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Siddiqui, S.; Sharma, R.K., 2003: Influence of fruit size on the quality and shelf life of kinnow mandarin. To examine the effects of fruit size on shelf life at ambient conditions, Kinnow mandarin fruits were harvested and graded into three sizes: (i) small, (ii) medium and (iii) large, based on an average weight of 105+or-3, 192+or-8 and 300+or-20 g,...