PHONO-DOPPLER TIMING RELATIONSHIPS IN PATIENTS WITH A 4TH HEART-SOUND

Controversies exist about the timing relationship between the fourth h eart sound and the ventricular inflow Doppler events. Besides, there h as been no data about the timing relationship between the fourth heart sound and the ventricular outflow Doppler events. This study was desi gned to measure these phono-Doppler timing relationships and to evalua te the influence of different Doppler modes on the timing relationship of the onset of the A wave. Twenty patients (61 +/- 9 years, 18 males and 2 females) with an audible and recordable fourth heart sound were included. No matter on the pulsed Doppler wave trace or on the contin uous-wave trace, both the interval from the onset of the mitral A wave to the first vibration. of the fourth heart sound and the interval fr om the peak velocity of the mitral A wave to the first vibration. of t he fourth heart sound differed significantly from zero (P < 0.001 for all). Nevertheless, the interval from the onset of the transmitted tra nsmitral A wave to the first vibration of the fourth heart sound (0.4 +/- 1.7 ms) was not significantly different from zero (P = 0.314). The pulsed wave data and the continuous wave data were significantly corr elated. Differences in the Doppler modes do not seem to lead to obviou s changes in the Doppler-phono timing relationships.