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ARTICLE |

Genesis of Heart Sounds FREE

Ravi Prakash, MD
JAMA. 1978;240(25):2732-2732. doi:10.1001/jama.1978.03290250036010
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To the Editor.—  In the article "Current Concepts of the Genesis of Heart Sounds: I. First and Second Sounds" (239:2787, 1978), Jonathan Abrams, MD, states that according to Luisada et al, the right ventricle and tricuspid valve play no role in the genesis of the normal S1, while Craige and others dispute this point. I would like to present some additional data to elucidate further this controversial subject.We performed a study to evaluate by echocardiography the relationship of mitral, tricuspid, and aortic valve motion with the simultaneously recorded S1, with particular emphasis on the role of aortic valve in the production of the second major component of S1.1 There were 20 subjects: 16 with no valvular or congenital heart disease and four with mitral valve disease. All 20 subjects had normal PR intervals. The mean interval between the onset of the Q wave of the ECG to mitral

REFERENCES

Prakash R, Moorthy K, Aronow W:  First heart sound: A phono-echocardiographic correlation with mitral, tricuspid, and aortic valvular events . Cathet Cardiovasc Diagn 2:381, 1976;.
Piemme TE, Barnett GO, Dexter L:  Relationship of heart sounds to acceleration of blood flow . Circ Res 18:303-315, 1966;.
Luisada AA, Kurz H, Slodki SJ, et al:  Normal first heart sounds with nonfunctional tricuspid valve or right ventricle: Clinical and experimental evidence . Circulation 35:119-125, 1967;.
Di Bartolo G, Nunez-Dey D, Muiesan G, et al:  Hemodynamic correlates of the first heart sound . Am J Physiol 201:888, 1961;.
Luisada AA, MacCanon DM, Coleman B, et al:  New studies on the first heart sound . Am J Cardiol 28:140-149, 1971;.

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Prakash R, Moorthy K, Aronow W:  First heart sound: A phono-echocardiographic correlation with mitral, tricuspid, and aortic valvular events . Cathet Cardiovasc Diagn 2:381, 1976;.
Piemme TE, Barnett GO, Dexter L:  Relationship of heart sounds to acceleration of blood flow . Circ Res 18:303-315, 1966;.
Luisada AA, Kurz H, Slodki SJ, et al:  Normal first heart sounds with nonfunctional tricuspid valve or right ventricle: Clinical and experimental evidence . Circulation 35:119-125, 1967;.
Di Bartolo G, Nunez-Dey D, Muiesan G, et al:  Hemodynamic correlates of the first heart sound . Am J Physiol 201:888, 1961;.
Luisada AA, MacCanon DM, Coleman B, et al:  New studies on the first heart sound . Am J Cardiol 28:140-149, 1971;.
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