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Effect of high flow arteriovenous fistula on cardiac function in hemodialysis patients

BACKGROUND: Vascular access for hemodialysis (HD) with an inappropriately high flow may underlie the onset of high output heart failure (HOHF). The aim of this study was to determine the prevalence of high flow access (HFA) in chronic HD patients, and to determine its effects on cardiac functions. M...

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Autores principales: Saleh, Mohamed Ayman, El Kilany, Wael Mahmoud, Keddis, Viola William, El Said, Tamer Wahid
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Egyptian Society of Cardiology 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303531/
https://www.ncbi.nlm.nih.gov/pubmed/30591752
http://dx.doi.org/10.1016/j.ehj.2018.10.007
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author Saleh, Mohamed Ayman
El Kilany, Wael Mahmoud
Keddis, Viola William
El Said, Tamer Wahid
author_facet Saleh, Mohamed Ayman
El Kilany, Wael Mahmoud
Keddis, Viola William
El Said, Tamer Wahid
author_sort Saleh, Mohamed Ayman
collection PubMed
description BACKGROUND: Vascular access for hemodialysis (HD) with an inappropriately high flow may underlie the onset of high output heart failure (HOHF). The aim of this study was to determine the prevalence of high flow access (HFA) in chronic HD patients, and to determine its effects on cardiac functions. METHODS: This cross sectional study was conducted on 100 chronic hemodialysis patients through arteriovenous fistula (AVF). The study cohort was subdivided into 2 groups based on AVF flow: Group A (Non-HFA group with Qa < 2000 ml/min), and Group B (HFA group with Qa ≥ 2000 ml/min). AVF flow (Qa) was assessed using Color Doppler ultrasonography. Transthoracic echocardiography was performed for all patients to assess cardiac dimensions and functions. RESULTS: Prevalence of HFA among study population was 24%. Mean AVF Qa was 958.63 ± 487.35 and 3430.13 ± 1256.28 ml/min, for group A and B respectively. The HFA group demonstrated a significant dilatation in LV dimensions and volumes and significantly larger LA volume as compared to non-HFA group. A significantly lower LV ejection fraction [EF] was also observed in group B with a mean value of 57.32 ± 6.19% versus 62.90 ± 5.76%. A significant association between HFA group and high Qa/cardiac output (CO) ratio (≥20%) was also observed. CONCLUSION: HFA is a prevalent hemodialysis vascular access problem. HFA was associated with dilated LV dimensions, impaired LV systolic function. High Qa/CO ratio (≥20%) was an independent predictor of high output heart failure (HOHF) in our study population.
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spelling pubmed-63035312018-12-27 Effect of high flow arteriovenous fistula on cardiac function in hemodialysis patients Saleh, Mohamed Ayman El Kilany, Wael Mahmoud Keddis, Viola William El Said, Tamer Wahid Egypt Heart J Cardiac Imaging BACKGROUND: Vascular access for hemodialysis (HD) with an inappropriately high flow may underlie the onset of high output heart failure (HOHF). The aim of this study was to determine the prevalence of high flow access (HFA) in chronic HD patients, and to determine its effects on cardiac functions. METHODS: This cross sectional study was conducted on 100 chronic hemodialysis patients through arteriovenous fistula (AVF). The study cohort was subdivided into 2 groups based on AVF flow: Group A (Non-HFA group with Qa < 2000 ml/min), and Group B (HFA group with Qa ≥ 2000 ml/min). AVF flow (Qa) was assessed using Color Doppler ultrasonography. Transthoracic echocardiography was performed for all patients to assess cardiac dimensions and functions. RESULTS: Prevalence of HFA among study population was 24%. Mean AVF Qa was 958.63 ± 487.35 and 3430.13 ± 1256.28 ml/min, for group A and B respectively. The HFA group demonstrated a significant dilatation in LV dimensions and volumes and significantly larger LA volume as compared to non-HFA group. A significantly lower LV ejection fraction [EF] was also observed in group B with a mean value of 57.32 ± 6.19% versus 62.90 ± 5.76%. A significant association between HFA group and high Qa/cardiac output (CO) ratio (≥20%) was also observed. CONCLUSION: HFA is a prevalent hemodialysis vascular access problem. HFA was associated with dilated LV dimensions, impaired LV systolic function. High Qa/CO ratio (≥20%) was an independent predictor of high output heart failure (HOHF) in our study population. Egyptian Society of Cardiology 2018-12 2018-11-16 /pmc/articles/PMC6303531/ /pubmed/30591752 http://dx.doi.org/10.1016/j.ehj.2018.10.007 Text en © 2018 Egyptian Society of Cardiology. Production and hosting by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Cardiac Imaging
Saleh, Mohamed Ayman
El Kilany, Wael Mahmoud
Keddis, Viola William
El Said, Tamer Wahid
Effect of high flow arteriovenous fistula on cardiac function in hemodialysis patients
title Effect of high flow arteriovenous fistula on cardiac function in hemodialysis patients
title_full Effect of high flow arteriovenous fistula on cardiac function in hemodialysis patients
title_fullStr Effect of high flow arteriovenous fistula on cardiac function in hemodialysis patients
title_full_unstemmed Effect of high flow arteriovenous fistula on cardiac function in hemodialysis patients
title_short Effect of high flow arteriovenous fistula on cardiac function in hemodialysis patients
title_sort effect of high flow arteriovenous fistula on cardiac function in hemodialysis patients
topic Cardiac Imaging
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303531/
https://www.ncbi.nlm.nih.gov/pubmed/30591752
http://dx.doi.org/10.1016/j.ehj.2018.10.007
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