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To determine the effect of changing the P-R interval on the intensity of the mitral component of the first heart sound (M1 amplitude), fixed-rate sequential atrioventricular pacing was used to vary the P-R interval in a steady hemodynamic state in six anesthetized dogs. Left ventricular sound and pressure events were monitored with a catheter-tip micromanometer, and the rate of rise of left ventricular pressure (dP/dt) was recorded using an R/C differentiator. The P-R interval was varied from the longest interval at which continuous ventricular capture was achieved (indifferent P-R interval) to 0.00 msec in 10-msec increments. The mean increase in M1 amplitude at the short P-R intervals (30 to 50 msec) was 119% compared to the amplitude at the indifferent P-R interval; there was no significant change in maximum dP/dt. No significant changes in left ventricular ejection time and left ventricular peak pressure occurred over the range of P-R intervals. At the indifferent P-R interval, a norepinephrine infusi...

Effect of Altering P-R Interval on the Amplitude of the First Heart Sound in the Anesthetized Dog