To the Editor.—
In the article "Current Concepts of the Genesis of Heart Sounds: I. First and Second Sounds" (239:2787, 1978), Jonathan Abrams, MD, states that according to Luisada et al, the right ventricle and tricuspid valve play no role in the genesis of the normal S1, while Craige and others dispute this point. I would like to present some additional data to elucidate further this controversial subject.We performed a study to evaluate by echocardiography the relationship of mitral, tricuspid, and aortic valve motion with the simultaneously recorded S1, with particular emphasis on the role of aortic valve in the production of the second major component of S1.1 There were 20 subjects: 16 with no valvular or congenital heart disease and four with mitral valve disease. All 20 subjects had normal PR intervals. The mean interval between the onset of the Q wave of the ECG to mitral
Prakash R. Genesis of Heart Sounds. JAMA. 1978;240(25):2732. doi:10.1001/jama.1978.03290250036010
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