title: [Significance of the fourth heart sound in patients with angina pectoris].
abstract: To determine the physiological significance of the fourth heart sound at rest in patients with angina pectoris without previous myocardial infarction, the tension time index (TTI) and the ratio of the diastolic pressure time index (DPTI) to (DPTI/TTI) were calculated from the recordings of the left ventricular and aortic pressure curves. Thirty patients were subjected to the study and they were classified into two groups: Group A consisted of 15 patients with the fourth heart sound and Group B of 15 patients without it. Nine cases of atypical chest pain without the fourth heart sound served as control group. TTI was significantly higher in Group A than in Group B (p less than 0.01) and control group (p less than 0.01) (2,552 +/- 489 mmHg X sec/min in Group A, 2,024 +/- 425 mmHg X sec/min in Group B, and 2,023 +/- 209 mmHg X sec/min in control group). DPTI/TTI was significantly lower in Group A than in Group B (p less than 0.01) and control group p less than 0.001) (1.16 +/- 0.19 in Group A, 1.55 +/- 0.39 in Group B, and 1.45 +/- 0.15 in control group). Left ventricular systolic pressure tended to be higher in Group A than in Group B and control group. There was no significant difference in left ventricular end-diastolic pressure, left ventricular ejection fraction and cardiac index among three groups and there was no difference in the prevalence of left ventricular asynergy on left ventriculography between Group A and Group B.(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000503:physiopathology*; D003326:Coronary Circulation; D005260:Female; D006326:Heart Auscultation; D006347:Heart Sounds; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D010101:Oxygen Consumption; D013318:Stroke Volume