Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/95665
Citations
Scopus Web of Science® Altmetric
?
?
Type: Journal article
Title: The deleterious effects of arteriovenous fistula-creation on the cardiovascular system: a longitudinal magnetic resonance imaging study
Author: Dundon, B.
Torpey, K.
Nelson, A.
Wong, D.
Duncan, R.
Meredith, I.
Faull, R.
Worthley, S.
Worthley, M.
Citation: International Journal of Nephrology and Renovascular Disease, 2014; 7:337-345
Publisher: Dove
Issue Date: 2014
ISSN: 1178-7058
1178-7058
Statement of
Responsibility: 
Benjamin K Dundon, Kim Torpey, A dam J Nelson, Dennis TL Wong, Rae F Duncan, Ian T Meredith, Randall J Faull, S tephen G Worthley, Matthew I Worthley
Abstract: 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.
Keywords: cardiac
cardiovascular disease
vascular biology
Rights: © 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. Permissions beyond the scope of the License are administered by Dove Medical Press Limited
DOI: 10.2147/IJNRD.S66390
Appears in Collections:Aurora harvest 3
Medicine publications

Files in This Item:
File Description SizeFormat 
hdl_95665.pdfPublished version442.45 kBAdobe PDFView/Open


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.