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RIGHT VENTRICULAR VOLUME
Volume 48, No.4 October 1965
AMPLITUDE OF FIRST HEART SOUND
Diese Beobachtungen erkHiren geniigend die divergierenden Auffassungen fmher Untersucher hinsichtlich der Variationen in der Amplitude des ersten Herztones bei VorhofHimmern. . REFERENCES LEWIS, T.: "Illustrations of Heart Sound Records," QNart. I. Med., 6:441, 1913. 2 BATTAERD, P. J. T. A.: "Further Graphic Researches on the Acoustic Phenomena of the Heart in Normal and Pathologic Conditions," Heart, 6: 121, 1915. 3 SELENIN, W. H. AND FOGELSON, L. I.: "Das Phonokardiogram bei Vorhomimmern," Ztschr. KreislaufJorsch., 21: 177, 1929. 4 WOLFERTH, C. C. AND MARGOLIES, A.: "Certain Effects of Auricular Systole and Prematurity of Beat on the Intensity of the First Heart Sound," Trans. .Asso. .Am. Physicians,
45: 44, 1930. 5 HERKEL, W. AND ZUR, G.: "Herzschallstudien bei Mitralstenose," Ztschr. Klin. Med., 137: 145, 1940. 6 COSSIO, P. AND BERCONSKY, I.: "Primer Ruido Cardiaco y Fibrilaci6n Auricular," Rev. Arg. Cardiol., 10: 283, 1943. 7 RYTAND, D. A.: "The Variable Loudness of the First Heart Sounds in Auricular Fibrillation," Am. Heart 1.,37:187, 1949. 8 HOLLDACK, K., WEYGAND, A. AND BSCHORR, F.: "V rsachen der Verspaetung und Verstaerkung des Ersten Hentones bei Mitralstenose und Absoluten Arrhythmie," Klin. Wschr., 28: 517, 1950. 9 RAVIN, A. AND BERSHOF, E.: "The Intensity of the Fnt Heart Sound in Auricular Fibrillation with Mitral Stenosis," Am. Heart J., 41: 539, 1951. 10 AUINGER, W.: "Veber die Lautstaerke des Ersten Hentones bei Arrhythmien," Ztschr. KreislaufJorsch., 44: 194, 1955. 11 MEDA, A. AND SCANSETTI, G.: "Phonocardiographic Investigation of the Variability of the First Heart Sound in Auricular Fibrillation," Cardiologia, 31: 144, 1957. 12 SAKAMOTO, T., KUSUKAWA, R., MACCANON, D. M. AND LUISADA, A. A.: "Hemodynamic Determinants of the Amplitude of the First Heart Sound," Circulation Res. (in press).
13 VEDA, H., KAITO, G. AND SAK.AMOTO, T.: Clinical Phonocardiography, Nanzando Co., Tokyo, 1963. 14 KATZ, L. AND FElL, H. B.: "Dynamics of 15 16
17
18
Auricular Fibrillation; Ventricular Systole," Arch. Int. Med., 32:672, 1923. RUSHMER, R. F., SMITH, O. AND FRANKLIN, D.: "Mechanism of Cardiac Control in Exercise," Circ. Res., 7: 602, 1959. GLEASON, W. L. AND BRAUNWALD, E.: "Studies on the First Derivative of the Ventricular Pressure Pulse in Man," J. Clin. Invest., 41: 80, 1962. WIGGERS, C. J.: "Pathological Physiology of the Heart. I. The Intra-auricular, Intraventricular and Aortic Pressure Curves in Auricular Fibrillations," Arch. Int. Med., 15:77, 1915. AUINGER, W.: "Ueber Veraenderungen der Lautstaerke des Enten Hentones Vnter der Wirkung eines Digitalisglykosids bei Absoluten Arrhythmien," Ztschr. KreislaufJorsch., 44:
889, 1955. 19 BUCKLEY, N. M. AND ZEIG, N. 20
21
22
23
J.: "Acute Unilateral Ventricular Failure in the Isolated Dog Heart," Am. J. Physiol., 197: 247, 1959. VAN BOOAERT, A., VAN GENABEEK, A., ARNOLDY, M., WAUTERS, J., VAN DER HENST, H., KEIRSEBELIK, M. AND VANDAEL, J.: "Contribution a l'ttude du Premier Bruit du Coeur Normal," Arch. Mal. Coeur, 55: 368, 1962. VAN BOOAERT, A., VAN GENABEEK., A., ARNOLDY, M., WAUTERS, J., VAN DER HENST, H., VANDAEL, J. AND KEIRSEBELIK, M.: "Influence d'une Fuite Systolique Ventriculaire sur l'Intensite du Premier Bruit du Coeur. Application a I'Insuffisance Mitrale," Arch. Mal. Coeur, 55 :961, 1962. VAN BoOAERT, A., VAN GENABEEK, A., ARNOLDY, M., WAUTERS, J., VAN DER HENST, H., KEIRSEBELIK, M. AND V ANDAEL, J.: "Comportement du Premier Bruit du Coeur dans la Stenose Aortique Clinique Experimentale," Arch. Mal. CoeNr, 56:40, 1963. SHAH, P. M., MORI, M., MACCANON, D. M. AND LUISADA, A. A.: "Hemodynamic Correlates of the Various Components of the Fint Heart Sound," Circ. Res., 12: 386, 1963.
For reprints, please write Dr. Aldo A. Luisada, 2020 West Ogden, Chicago.
RIGHT VENTRICULAR VOLUME The authors measured right ventricular volumes In 15 subjects without heart disease and In ten with congestive heart failure secondary to left ventricular disease. The residual fractions were determined from pulmonary artery thermodilution curves following Injections of cold sallne Into the right ventricle. Stroke output was measured simultaneously from a direct Fick cardiac output, permitting calculation of absolute end-systollc and end-tUastoile volumes. The ratio end-systollc volume /dlastoile volume averaged 53.4 per cent In subjects without heart disease and was significantly higher, averaging 71.9 per cent, in the patients with congestive heart failure. Although absolute right ventricular
end-dlastollc volume was occasionally Increased. most patients with congestive heart fallure had enddiastollc volumes In the normal range at rest. Moderate exercise In the recumbent position generally decreased the residual fraction in subjects without heart disease without a significant change In enddiastollc volume; in contrast, patients with congestive heart failure increased both residual fraction and absolute end-diastollc volumes with exercise. RAPAPORT,
E..
WONG,
M.,
FERGUSON,
R. E.,
BEIlNSTBIN,
P.
B. D.: •'Right Ventricular Volumes in Patients with and without Heart Failure, eireIlJ.,ion, 31 :531.
AND WIEGAND,
It
19~5.
AMPLITUDE OF FIRST HEART SOUND
Diese Beobachtungen erkHiren geniigend die divergierenden Auffassungen fmher Untersucher hinsichtlich der Variationen in der Amplitude des ersten Herztones bei VorhofHimmern. . REFERENCES LEWIS, T.: "Illustrations of Heart Sound Records," QNart. I. Med., 6:441, 1913. 2 BATTAERD, P. J. T. A.: "Further Graphic Researches on the Acoustic Phenomena of the Heart in Normal and Pathologic Conditions," Heart, 6: 121, 1915. 3 SELENIN, W. H. AND FOGELSON, L. I.: "Das Phonokardiogram bei Vorhomimmern," Ztschr. KreislaufJorsch., 21: 177, 1929. 4 WOLFERTH, C. C. AND MARGOLIES, A.: "Certain Effects of Auricular Systole and Prematurity of Beat on the Intensity of the First Heart Sound," Trans. .Asso. .Am. Physicians,
45: 44, 1930. 5 HERKEL, W. AND ZUR, G.: "Herzschallstudien bei Mitralstenose," Ztschr. Klin. Med., 137: 145, 1940. 6 COSSIO, P. AND BERCONSKY, I.: "Primer Ruido Cardiaco y Fibrilaci6n Auricular," Rev. Arg. Cardiol., 10: 283, 1943. 7 RYTAND, D. A.: "The Variable Loudness of the First Heart Sounds in Auricular Fibrillation," Am. Heart 1.,37:187, 1949. 8 HOLLDACK, K., WEYGAND, A. AND BSCHORR, F.: "V rsachen der Verspaetung und Verstaerkung des Ersten Hentones bei Mitralstenose und Absoluten Arrhythmie," Klin. Wschr., 28: 517, 1950. 9 RAVIN, A. AND BERSHOF, E.: "The Intensity of the Fnt Heart Sound in Auricular Fibrillation with Mitral Stenosis," Am. Heart J., 41: 539, 1951. 10 AUINGER, W.: "Veber die Lautstaerke des Ersten Hentones bei Arrhythmien," Ztschr. KreislaufJorsch., 44: 194, 1955. 11 MEDA, A. AND SCANSETTI, G.: "Phonocardiographic Investigation of the Variability of the First Heart Sound in Auricular Fibrillation," Cardiologia, 31: 144, 1957. 12 SAKAMOTO, T., KUSUKAWA, R., MACCANON, D. M. AND LUISADA, A. A.: "Hemodynamic Determinants of the Amplitude of the First Heart Sound," Circulation Res. (in press).
13 VEDA, H., KAITO, G. AND SAK.AMOTO, T.: Clinical Phonocardiography, Nanzando Co., Tokyo, 1963. 14 KATZ, L. AND FElL, H. B.: "Dynamics of 15 16
17
18
Auricular Fibrillation; Ventricular Systole," Arch. Int. Med., 32:672, 1923. RUSHMER, R. F., SMITH, O. AND FRANKLIN, D.: "Mechanism of Cardiac Control in Exercise," Circ. Res., 7: 602, 1959. GLEASON, W. L. AND BRAUNWALD, E.: "Studies on the First Derivative of the Ventricular Pressure Pulse in Man," J. Clin. Invest., 41: 80, 1962. WIGGERS, C. J.: "Pathological Physiology of the Heart. I. The Intra-auricular, Intraventricular and Aortic Pressure Curves in Auricular Fibrillations," Arch. Int. Med., 15:77, 1915. AUINGER, W.: "Ueber Veraenderungen der Lautstaerke des Enten Hentones Vnter der Wirkung eines Digitalisglykosids bei Absoluten Arrhythmien," Ztschr. KreislaufJorsch., 44:
889, 1955. 19 BUCKLEY, N. M. AND ZEIG, N. 20
21
22
23
J.: "Acute Unilateral Ventricular Failure in the Isolated Dog Heart," Am. J. Physiol., 197: 247, 1959. VAN BOOAERT, A., VAN GENABEEK, A., ARNOLDY, M., WAUTERS, J., VAN DER HENST, H., KEIRSEBELIK, M. AND VANDAEL, J.: "Contribution a l'ttude du Premier Bruit du Coeur Normal," Arch. Mal. Coeur, 55: 368, 1962. VAN BOOAERT, A., VAN GENABEEK., A., ARNOLDY, M., WAUTERS, J., VAN DER HENST, H., VANDAEL, J. AND KEIRSEBELIK, M.: "Influence d'une Fuite Systolique Ventriculaire sur l'Intensite du Premier Bruit du Coeur. Application a I'Insuffisance Mitrale," Arch. Mal. Coeur, 55 :961, 1962. VAN BoOAERT, A., VAN GENABEEK, A., ARNOLDY, M., WAUTERS, J., VAN DER HENST, H., KEIRSEBELIK, M. AND V ANDAEL, J.: "Comportement du Premier Bruit du Coeur dans la Stenose Aortique Clinique Experimentale," Arch. Mal. CoeNr, 56:40, 1963. SHAH, P. M., MORI, M., MACCANON, D. M. AND LUISADA, A. A.: "Hemodynamic Correlates of the Various Components of the Fint Heart Sound," Circ. Res., 12: 386, 1963.
For reprints, please write Dr. Aldo A. Luisada, 2020 West Ogden, Chicago.
RIGHT VENTRICULAR VOLUME The authors measured right ventricular volumes In 15 subjects without heart disease and In ten with congestive heart failure secondary to left ventricular disease. The residual fractions were determined from pulmonary artery thermodilution curves following Injections of cold sallne Into the right ventricle. Stroke output was measured simultaneously from a direct Fick cardiac output, permitting calculation of absolute end-systollc and end-tUastoile volumes. The ratio end-systollc volume /dlastoile volume averaged 53.4 per cent In subjects without heart disease and was significantly higher, averaging 71.9 per cent, in the patients with congestive heart failure. Although absolute right ventricular
end-dlastollc volume was occasionally Increased. most patients with congestive heart fallure had enddiastollc volumes In the normal range at rest. Moderate exercise In the recumbent position generally decreased the residual fraction in subjects without heart disease without a significant change In enddiastollc volume; in contrast, patients with congestive heart failure increased both residual fraction and absolute end-diastollc volumes with exercise. RAPAPORT,
E..
WONG,
M.,
FERGUSON,
R. E.,
BEIlNSTBIN,
P.
B. D.: •'Right Ventricular Volumes in Patients with and without Heart Failure, eireIlJ.,ion, 31 :531.
AND WIEGAND,
It
19~5.