The deleterious effects of arteriovenous fistula-creation on the cardiovascular system: a longitudinal magnetic resonance imaging study
AIM: Arteriovenous fistula-formation remains critical for the provision of hemodialysis in end-stage renal failure patients. Its creation results in a significant increase in cardiac output, with resultant alterations in cardiac stroke volume, systemic blood flow, and vascular resistance. The impact...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove Medical Press
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172192/ https://www.ncbi.nlm.nih.gov/pubmed/25258554 http://dx.doi.org/10.2147/IJNRD.S66390 |
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author | Dundon, Benjamin K Torpey, Kim Nelson, Adam J Wong, Dennis TL Duncan, Rae F Meredith, Ian T Faull, Randall J Worthley, Stephen G Worthley, Matthew I |
author_facet | Dundon, Benjamin K Torpey, Kim Nelson, Adam J Wong, Dennis TL Duncan, Rae F Meredith, Ian T Faull, Randall J Worthley, Stephen G Worthley, Matthew I |
author_sort | Dundon, Benjamin K |
collection | PubMed |
description | AIM: Arteriovenous fistula-formation remains critical for the provision of hemodialysis in end-stage renal failure patients. Its creation results in a significant increase in cardiac output, with resultant alterations in cardiac stroke volume, systemic blood flow, and vascular resistance. The impact of fistula-formation on cardiac and vascular structure and function has not yet been evaluated via “gold standard” imaging techniques in the modern era of end-stage renal failure care. METHODS: A total of 24 patients with stage 5 chronic kidney disease undergoing fistula-creation were studied in a single-arm pilot study. Cardiovascular magnetic resonance imaging was undertaken at baseline, and prior to and 6 months following fistula-creation. This gold standard imaging modality was used to evaluate, via standard brachial flow-mediated techniques, cardiac structure and function, aortic distensibility, and endothelial function. RESULTS: At follow up, left ventricular ejection fraction remained unchanged, while mean cardiac output increased by 25.0% (P<0.0001). Significant increases in left and right ventricular end-systolic volumes (21% [P=0.014] and 18% [P<0.01]), left and right atrial area (11% [P<0.01] and 9% [P<0.01]), and left ventricular mass were observed (12.7% increase) (P<0.01). Endothelial-dependent vasodilation was significantly decreased at follow up (9.0%±9% vs 3.0%±6%) (P=0.01). No significant change in aortic distensibility was identified. CONCLUSION: In patients with end-stage renal failure, fistula-formation is associated with an increase in cardiac output, dilation of all cardiac chambers and deterioration in endothelial function. |
format | Online Article Text |
id | pubmed-4172192 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-41721922014-09-25 The deleterious effects of arteriovenous fistula-creation on the cardiovascular system: a longitudinal magnetic resonance imaging study Dundon, Benjamin K Torpey, Kim Nelson, Adam J Wong, Dennis TL Duncan, Rae F Meredith, Ian T Faull, Randall J Worthley, Stephen G Worthley, Matthew I Int J Nephrol Renovasc Dis Original Research AIM: Arteriovenous fistula-formation remains critical for the provision of hemodialysis in end-stage renal failure patients. Its creation results in a significant increase in cardiac output, with resultant alterations in cardiac stroke volume, systemic blood flow, and vascular resistance. The impact of fistula-formation on cardiac and vascular structure and function has not yet been evaluated via “gold standard” imaging techniques in the modern era of end-stage renal failure care. METHODS: A total of 24 patients with stage 5 chronic kidney disease undergoing fistula-creation were studied in a single-arm pilot study. Cardiovascular magnetic resonance imaging was undertaken at baseline, and prior to and 6 months following fistula-creation. This gold standard imaging modality was used to evaluate, via standard brachial flow-mediated techniques, cardiac structure and function, aortic distensibility, and endothelial function. RESULTS: At follow up, left ventricular ejection fraction remained unchanged, while mean cardiac output increased by 25.0% (P<0.0001). Significant increases in left and right ventricular end-systolic volumes (21% [P=0.014] and 18% [P<0.01]), left and right atrial area (11% [P<0.01] and 9% [P<0.01]), and left ventricular mass were observed (12.7% increase) (P<0.01). Endothelial-dependent vasodilation was significantly decreased at follow up (9.0%±9% vs 3.0%±6%) (P=0.01). No significant change in aortic distensibility was identified. CONCLUSION: In patients with end-stage renal failure, fistula-formation is associated with an increase in cardiac output, dilation of all cardiac chambers and deterioration in endothelial function. Dove Medical Press 2014-09-16 /pmc/articles/PMC4172192/ /pubmed/25258554 http://dx.doi.org/10.2147/IJNRD.S66390 Text en © 2014 Dundon et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Dundon, Benjamin K Torpey, Kim Nelson, Adam J Wong, Dennis TL Duncan, Rae F Meredith, Ian T Faull, Randall J Worthley, Stephen G Worthley, Matthew I The deleterious effects of arteriovenous fistula-creation on the cardiovascular system: a longitudinal magnetic resonance imaging study |
title | The deleterious effects of arteriovenous fistula-creation on the cardiovascular system: a longitudinal magnetic resonance imaging study |
title_full | The deleterious effects of arteriovenous fistula-creation on the cardiovascular system: a longitudinal magnetic resonance imaging study |
title_fullStr | The deleterious effects of arteriovenous fistula-creation on the cardiovascular system: a longitudinal magnetic resonance imaging study |
title_full_unstemmed | The deleterious effects of arteriovenous fistula-creation on the cardiovascular system: a longitudinal magnetic resonance imaging study |
title_short | The deleterious effects of arteriovenous fistula-creation on the cardiovascular system: a longitudinal magnetic resonance imaging study |
title_sort | deleterious effects of arteriovenous fistula-creation on the cardiovascular system: a longitudinal magnetic resonance imaging study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172192/ https://www.ncbi.nlm.nih.gov/pubmed/25258554 http://dx.doi.org/10.2147/IJNRD.S66390 |
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