The third heart sound after exercise in athletes: an exploratory study.

The purpose of our study was to investigate the frequency of the third heart sound (S3) of athletes after exercise, and to determine whether the frequency and amplitude of S3 were related to cardiac function. The phonocardiogram exercise test (PCGET) was used in this study, and healthy volunteers consisting of 84 athletes (age 21.0±1.7 years; 62 males and 22 females) and 45 non-athletes (age 24.1±2.0 years; 33 males and 12 females) were enrolled. All subjects were healthy except one with a cardiac murmur without known cause. Immediately after exercise, S3 occurred in 21 athletes (25.0%) and 10 non-athletes (22.2%) during PCGET. There were very significant differences between pre-exercise and post-exercise in the frequency of S3 (P<0.01), and no significant difference between athletes and nonathletes (P>0.05). The prevalence of S3/S2≥1 was significantly (P<0.05) higher for the athlete group (47.1%) as compared to the non-athlete group (10%). Those results indicated that the emergence of S3 was an indicator of heart burden, and S3 after exercise in the athlete group was physiological. Our study showed that the amplitude of S3 had a very sensitive response to cardiac function reduction and S3/S2≥1 could eventually be used to assess cardiac fatigue states.

Change of cardiac reserve during abnormal pregnancy and its evaluation / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the change of cardiac reserve during abnormal pregnancy and explore its evaluation methods.</p><p><b>METHODS</b>Totally 96 women with abnormal pregnancies (AP group), 356 women with normal pregnancies (NP group), and 100 women of childbearing age (CBA group) were monitored by the exercise cardiac contractility monitor (ECCM). Phonocardiogram of participants at resting status was recorded by ECCM. The amplitude of first heart sound (S1), the amplitude of second heart sound (S2), cardiac cycle, diastolic duration (D), and systolic duration (S) were detected and then the S1/S2 ratio,the D/S ratio, and heart rate (HR) were calculated.</p><p><b>RESULTS</b>Compared with the CBA group, S1/S2 ratio and HR were significantly higher and D/S was significantly lower in both AP group and NP group (all P<0.001). Compared with the NP group, S1/S2 ratio and HR were significantly higher in AP group and D/S was significnatly lower (all P<0.001). A D/S ratio less than 1.1 or S1/S2 ratio higher than 1.8 was associated with higher risk of poor pregnancy outcomes. Among four common pregnancy-associated abnormalities, the level of cardiac reserve was lowest in eclampsia, followed by twins, gestational diabetes mellitus, and gestational hypertension.</p><p><b>CONCLUSIONS</b>Cardiac reserve is mobilized during pregnancy, and is especially during the abnormal pregnancies due to the heavy cardiac burden. S1/S2 ratio, D/S ratio, and HR are useful in evaluating the cardiac reserve during abnormal pregnancy.</p>

[Research on a new method and index for evaluating cardiac function of the athletes].

OBJECTIVE: To explore the new indexes and new methods for the noninvasive measuring and evaluating cardiac function detection of the athletes. METHODS: Heart sound signals were sampled randomly from 81 students in physical education department (experiment group) and 41 students in general departments (control group) after completing designed workload during step-climbing exercise, the contrast study on heart rate, D/S ratio as well as the S1/S2 ratio of students from physical education and general department has been conducted. RESULTS: In the resting state, the physical education department students' heart rate and D/S ratio was 66 +/- 8.7 and 2.04 +/- 0.33 respectively; general department students' heart rate and D/S ratio was 71 +/- 8.0 and 1.82 +/- 0.27 respectively. In the whole exercise, the physical education department students S1/S2 ratio was 7.34 +/- 4.04; general department students S1/S2 ratio was 5.22 +/- 2.38. CONCLUSION: Students from physical education department have higher level of cardiac reserve than that of students from general department. The method can evaluate cardiac reserve for athletes and general persons, and provide a new quantity evaluation index for selecting athletes and evaluating cardiac function of general persons.

[Clinical analysis of cardiac reserve function and outcome of preeclampsia.].

OBJECTIVE: To investigate cardiac reserve function and pregnant results of preeclampsia. METHODS: Pregnant women chosen by randomized table and hospitalized in the department of obstetrics of the first affiliated hospital of Chongqing Medical University were involved in this study from January to December, 2008. Sixty-nine cases of normal pregnant women were divided into 3 groups: normal group 1 (20 cases), normal group 2 (26 cases) and normal group 3 (23 cases). The normal group number 1 to number 3 were paired to gestational hypertension (20 cases), mild preeclampsia (26 cases) and severe preeclampsia (23 cases), respectively. The digital technique of heart sound signal processing was used to measure cardiac reserve function parameters including the heart rate (HR), the ratio of the amplitude of the first heart sound to the second heart sound (S1/S2) and the ratio of diastolic to systolic duration (D/S) of pregnant women. The pregnant results were also recorded. RESULTS: (1) The ratio of S1/S2 in the group of severe preeclampsia 4.5 +/- 3.2 was significantly higher than the group of gestational hypertension 2.2 +/- 1.1 and normal group 3 2.2 +/- 1.1 (P < 0.01). The ratio of D/S of the group of severe preeclampsia 1.1 +/- 0.3 was significantly lower than the group of gestational hypertension 1.4 +/- 0.3 and normal group 3 1.4 +/- 0.2 (P < 0.01). (2) All cases of the normal group number 1 to number 3 and the group of gestational hypertension were found the ratio of D/S >/= 1.00, whereas 1 case (1/26, 4%) of the group of mild preeclampsia and 4 cases (4/23, 17%) of the group of severe preeclampsia were found the ratio of D/S < 1.00. (3) The two cases of the pregnant women (including one woman died of cardiac arrest) with S1/S2 > 5.00 and D/S < 1.00, who were in the group of severe preeclampsia, were sent to Intensive Care Unit after delivery. There were 4 cases (4/26, 15%) and 6 cases (6/23, 26%) of 1 minute Apgar score less than 7, 7 cases (7/26, 27%) and 6 cases (6/23, 26%) sent to neonatal Intensive Care Unit, 2 cases (2/26, 8%) and 4 cases (4/23, 17%) of neonatal death in the group of mild preeclampsia and in the group of severe preeclampsia, respectively. All newborns in the normal group number 1 to number 3 and the group of gestational hypertension were normal. CONCLUSIONS: The cardiac reserve function of a pregnant woman with preeclampsia is decreased with the severity of preeclampsia and the parturient and neonatal results get worse. The digital technique of heart sound signal processing is a safe, harmless, simple and effective tool to measure cardiac reserve function of preeclampsia, and is worthy of widely used clinically.