Phonocardiography as a monitor of cardiac performance during anesthesia.

The usefulness of phonocardiography as a monitor of cardiac performance during anesthesia was investigated in six dogs. Anesthetic depression by halothane, isoflurane and nitrous oxide was demonstrated by the phonocardiogram. Likewise, the stimulating effect of dopamine clearly showed in the recordings.

The first heart sound in normal and pathological conditions.

Considerations of the physical basis of cardiac contraction and sound generation explain the mechanism of the first sound. Older theories examining this sound as the result of valve closure or stiffening are refuted. It has been demonstrated that the normal first sound originates in the left ventricle alone and that accelerations and decelerations, "timed" by mitral and aortic valves events, are its cause.

New index of cardiac contractility during stress testing with treadmill.

Experimental demonstration that the external phonocardiogram is similar to the third derivative (rate of acceleration) of LV pressure, and that catecholamines cause a similar increase of the early systolic wave of the first derivative of LV pressure and of S1 prompted a study of the first sound during stress testing. Following a previous study with different types of ergometers, the present investigation was based on records of 10 normal, young volunteers, taken during treadmill exercise while a phonocardiogram was recorded at the apex. The first heart sound increased in all of them averaging an eightfold increase during maximal stress.

Noninvasive index of cardiac contractility during stress testing: a collaborative study.

The present study was conducted in parallel in three different institutions with a similar purpose but using different technical setups. Based on the experimental demonstration that the external phonocardiogram is similar to the rate of acceleration (d3P/d3t) of the left ventricular pressure, and that catecholamines in a similar way increase the early positive wave of the left ventricular pressure and the first heart sound (S1) of the external phonocardiogram; knowing that exercise causes secretion of catecholamines and sympathetic reflexes, we have studied the S1 changes as a result of exertion in 34 normal young subjects. Blood pressure, heart rate, electrocardiograph, and phonocardiograph recordings of each subject were taken.