Relationship between amplitude and timing of heart sounds and endocardial acceleration.
OBJECTIVE
To study the correlation between heart sounds and peak endocardial acceleration (PEA) amplitudes and timings, by modulation of paced atrioventricular (AV) delay in recipients of dual chamber pacemakers.


METHODS
Ten recipients of dual chamber pacemakers implanted for high-degree AV block were studied. Endocardial acceleration (EA) and phonocardiographic and electrocardiographic signals were recorded during performance of an AV delay scan in VDD and DDD modes.


RESULTS
First PEA (PEA I) and first heart sound (S1) changed similarly with the AV delay. A close intrapatient correlation was observed between S1 and PEA I amplitudes in all patients (P < 0.0001). The interpatient normalized PEA I to S1 amplitudes correlation was r = 0.89 (P < 0.0001) in DDD mode, and r = 0.81 (P < 0.0001) in VDD mode. The mean cycle-by-cycle PEA I to S1 delay was -4.3 +/- 22 ms and second PEA (PEA II) to second heart sound (S2) delay was -7.7 +/- 15 ms.


CONCLUSIONS
A close correlation was observed between PEA I and S1 amplitudes and timings, and between PEA II and S2 timings. These observations support the hypothesis that PEA and heart sounds are manifestations of the same phenomena. EA might be a useful tool to monitor cardiac function.
Tassin
Aude
A
University Hospital, Angers, France. audetassin@yahoo.fr
Kobeissi
Adonis
A
Vitali
Luca
L
Rouleau
Frédéric
F
Ritter
Philippe
P
Gaggini
Guido
G
Dupuis
Jean-Marc
JM
D000054:Acceleration; D000368:Aged; D000369:Aged, 80 and over; D054537:Atrioventricular Block / Q000503:physiopathology* / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D004699:Endocardium / Q000503:physiopathology*; D005260:Female; D006326:Heart Auscultation / Q000379:methods*; D006347:Heart Sounds; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013018:Sound Spectrography / Q000379:methods; D013223:Statistics as Topic; D013997:Time Factors; D016896:Treatment Outcome