title: Phono-Doppler Timing Relationships in Patients with a Fourth Heart Sound.
abstract: Controversies exist about the timing relationship between the fourth heart sound and the ventricular inflow Doppler events. Besides, there has been no data about the timing relationship between the fourth heart sound and the ventricular outflow Doppler events. This study was designed to measure these phono-Doppler timing relationships and to evaluate 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 continuous-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 from the peak velocity of the mitral A wave to the first vibration of the fourth heart sound differed significantly from zero (P < 0.001 for all). Nevertheless, the interval from the onset of the transmitted transmitral 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 correlated. Differences in the Doppler modes do not seem to lead to obvious changes in the Doppler-phono timing relationships.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical College, No. 100, Shih-Chuan 1st Road, Koahsiung City 807, Taiwan wcvoonnn@ms2.hinet.net
authors.forename: Wel-Chol
authors.initials: WC
authors.lastname: Voon
authors.forename: Sheng-Hsiung
authors.initials: SH
authors.lastname: Sheu