If you set anything other than 44100Hz, all the playback is messed up. Things aren't properly re-sampled.
It's quite evident if you set the sample rate to 8000Hz, for example, and everything is completely slowed down. If you try to play a song, the notes on the fretboard finish long before the music does.
Similar things happen if you set the sample rate to 48000Hz (but not quite as noticeable).