Prevalence of regurgitant murmurs in patients with valvular regurgitation detected by Doppler echocardiography

Article Abstract:

Heart valves direct the flow of blood from one compartment of the heart to an other, and consist of four types. The mitral valve is located between the left atrium and ventricle; the tricuspid between the right atrium and ventricle; the pulmonic between the right ventricle and pulmonary artery (the blood vessel to the lungs); and the aortic valve is between the left ventricle and the aorta (a major blood vessel carrying oxygenated blood throughout the body). Valvular regurgitation is the backflow of blood through a heart valve due to impaired valve function. The relation between Doppler echocardiography, a diagnostic method using sound waves to visualize internal heart structures, and presence of murmurs (unusual heart sounds) in identifying valvular regurgitation was assessed in 408 patients undergoing these two examination procedures. Valvular regurgitation was detected at the mitral valve in 43 percent of the patients, at the tricuspid valve in 39 percent, at the aortic valve in 33 percent, and at the pulmonic valve in 15 percent. Murmurs associated with regurgitation were often absent, but increased with severity of the regurgitation. Heart murmurs associated with Doppler-detected regurgitation were observed in 56 percent of patients with mitral regurgitation, 61 percent of patients with aortic regurgitation, 28 percent of patients with tricuspid regurgitation, and 15 percent of patients with pulmonic regurgitation. The results show that Doppler echocardiography is a useful method for detecting valvular regurgitation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Heart valve diseases, Doppler echocardiography

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Increased serum aluminum: an independent risk factor for mortality in patients undergoing long-term hemodialysis

Article Abstract:

Between 1982 and 1988 the annual mortality among patients undergoing dialysis increased from 20 percent to 23.4 percent, and this increase does not seem to be related to age, disease, or duration of dialysis. Research suggests that increased body aluminum levels, even without actual signs of aluminum poisoning, may be factor in these deaths. Aluminum salts are given orally to control phosphorus levels in the blood. To test the effects of aluminum, records were reviewed for 10,646 dialysis patients for whom aluminum levels and survival and other demographic data were available. Almost all of the patients had aluminum levels above normal. It seems that aluminum levels in the body increase with the length of time the patient has been on dialysis. Increased aluminum levels may adversely affect on enzyme activity, cell division and fats, and may also affect parathyroid hormone. As the amount of aluminum increases, so does the risk of death, especially once the aluminum concentration exceeds 1,480 nmol per liter. This has probably contributed to the increase in mortality among hemodialysis patients during the 1980s. The finding that patients with low serum aluminum levels have better survival rates provides further evidence that high aluminum levels contribute to mortality among dialysis patients. The value of using aluminum salts to control phosphorus levels should be reassessed, especially among patients who already have high aluminum levels in their blood. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Complications and side effects, Aluminum in the body, Aluminum (Nutrient)

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Transmitted murmurs in patients undergoing hemodialysis

Article Abstract:

Forty hemodialysis patients were examined for bruits (an abnormal sound usually caused by blood flowing through a narrowed blood vessel and heard with a stethoscope) in the blood vessels of their arm that are used as an access for dialysis, which involves a shunt between an artery and a vein for the removal of waste and excess fluid from the blood in patients with kidney failure. By listening with a stethoscope while compressing these vessels, trained professionals can use the fistula compression technique to distinguish between bruits originating from the shunts and bruits which may be caused by heart valves. It was found that in hemodialysis patients with forearm access, bruits were heard on the same side near the neck and clavicle (collarbone). In 80 percent of the patients who have an upper arm access for dialysis, bruits were heard on the same side at the edge of the sternum (breastbone).

Physiological aspects, Heart, Heart sounds

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