Armstrong T G, Mitha A S, Matisonn R E, Weir E K, Chesler E
Br Heart J. 1978 Jul;40(7):750-7. doi: 10.1136/hrt.40.7.750.
The initial low frequency component of the first heart sound, 'M', has been studied in normal subjects, and in patients with vario-s prosthetic mitral valves and with mitral stenosis, using simultaneous low frequency phonocardiography, echocardiography, and apex cardiography. The techniques showed 'M' to have a constant morphology in preisovolumic systole. In mitral stenosis, 'M' and the preisovolumic 'presystolic' murmur appear to be the same phonocardiographic phenomenon. While 'M' was present in sinus rhythm, augmentation of this normal vibration occurred particularly during the short cycles of atrial fibrillation. Leaflet coaption and movement of the ventricular wall as detected echocardiographically do not appear to play a role in its pathogenesis but the sound could emanate from the ventricular wall as it tautens and decreases its compliance at the onset of systole.
利用同步低频心音图、超声心动图和心尖心动图，对正常受试者、各种人工机械二尖瓣患者以及二尖瓣狭窄患者的第一心音的初始低频成分“M”进行了研究。这些技术显示，“M”在等容收缩前期具有恒定的形态。在二尖瓣狭窄时，“M”和等容收缩前期的“收缩期前”杂音似乎是相同的心音图现象。虽然“M”出现在窦性心律中，但这种正常振动的增强尤其发生在房颤的短周期内。超声心动图检测到的瓣叶对合和心室壁运动似乎在其发病机制中不起作用，但该声音可能在收缩期开始时心室壁绷紧并降低其顺应性时由心室壁发出。
