JULIO E. PÉREZ, M.D.; CAROL A. SMITH; VICTOR N. MELTZER, M.D.
PÉREZ JE, SMITH CA, MELTZER VN. Pulmonic Valve Insufficiency: A Common Cause of Transient Diastolic Murmurs in Renal Failure. Ann Intern Med. 1985;103:497-502. doi: 10.7326/0003-4819-103-4-497
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Published: Ann Intern Med. 1985;103(4):497-502.
To study the transient diastolic murmur associated with renal failure, we used Doppler echocardiography to characterize flow across the semilunar valves in 10 patients on chronic hemodialysis with a diastolic murmur (group A), 26 patients on chronic hemodialysis without murmurs (group B), and 15 healthy persons (group C). Nine patients in group A had pulmonic valve insufficiency that encompassed 77 ± 21% (SD) of diastole with peak regurgitant flow velocities of 1.7 ± 0.3 m/s. Doppler-calculated mean pulmonary artery pressure in 8 of them was 43 ± 7 mm Hg before dialysis and 20 ± 12 mm Hg afterward (p < 0.001). Dialysis reduced the duration of pulmonic insufficiency to 10 ± 16% of diastole and lowered peak regurgitant flow velocities to 0.2 ± 0.2 m/s (p < 0.001 for each). Three patients in group B had aortic valve insufficiency and 3 had pulmonic valve insufficiency like that in group A. Three persons in group C had mild pulmonic valve insufficiency. Thus, transient diastolic murmurs associated with pulmonic valve insufficiency are not uncommon in patients with renal failure; they are related to fluid overload, are diminished by extracellular fluid removal, and reflect correctable pulmonary hypertension.
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Cardiology, Nephrology, Valvular Heart Disease.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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