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Doppler Study of Transmitted Transmitral A Wave in Patients with a Fourth Heart Sound
Author(s) -
VOON WENCHOL,
SHEU SHENGHSIUNG,
HWANG YUHYAU
Publication year - 1997
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.1997.tb00716.x
Subject(s) - cardiology , medicine , doppler effect , heart rate , sound (geography) , acceleration , ventricular outflow tract , mitral valve , doppler echocardiography , physics , acoustics , diastole , blood pressure , classical mechanics , astronomy
To investigate the characters of the transmitted transmitral A wave associated with a fourth heart sound, left ventricular inflow, and outflow Doppler echocardiography and phonocardiography were recorded in 13 patients with a fourth heart sound and 9 age‐matched control subjects. The Doppler echocardiographic data were compared between both groups and the peak velocity and acceleration rate of the transmitted transmitral A wave were correlated with other parameters. The peak velocity and acceleration rate of the transmitted transmitral A wave were significantly greater, but the A wave transit time from the mitral valve to the left ventricular outflow tract (A‐Ar interval) was significantly shorter in patients with a fourth heart sound. There was a significant correlation between the A‐Ar interval and the peak velocity (r = ‐0.54, P = 0.01) or acceleration rate (r = ‐0.63, P = 0.002) of the transmitted transmitral A wave. The A‐Ar interval was shown to be the independent determinant of both the peak velocity and acceleration rate of the transmitted transmitral A wave by stepwise multiple linear regression. In conclusion, the presence of a fourth heart sound was associated with a higher peak velocity and acceleration rate of the transmitted transmitral A wave, to which increased ventricular stiffness may make some contributions.