Hemodynamic Determinants of the Amplitude of the First Heart Sound

Abstract

The relationships between the amplitude of the first heart sound and various hemodynamic parameters and their analog functions were systematically investigated in 51 dogs under morphine and pentobarbital anesthesia. Simultaneous hemodynamic and phonocardiographic tracings were obtained by cardiac catheterization, high speed recording, and analog computers. Changes in cardiodynamics were induced by: l -epinephrine, levarterenol, phenylephrine, isoproterenol, methoxamine, veratrine, vasopressin, histamine, atropine, saline infusion, mechanical obstruction of the aorta, pulmonary artery, or both venae cavae, embolization of the coronary arteries with plastic microspheres, mechanical rupture of aortic valve leaflets, or hemorrhage. In this way, the relationships were examined over a wide range of pressures, volumes, and cardiodynamics. The results showed that the amplitude of the first sound is not directly related to stroke output, P-R interval, heart rate, end diastolic, or systolic ventricular or aortic pressures. Only the peak rate of rise of left ventricular systolic pressure (first derivative maximum) had a consistent relationship to first sound amplitude. The right ventricle seems to contribute very little to the external first sound. These observations suggest that the amplitude of the first sound is related to left ventricular contractility.