The effect of high-flow arteriovenous fistulas on systemic haemodynamics and brain oxygenation

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F21%3A10427896" target="_blank" >RIV/00216208:11110/21:10427896 - isvavai.cz</a>

Alternative codes found

RIV/00064165:_____/21:10427896

Result on the web

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=4R6BQPf24q" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=4R6BQPf24q</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1002/ehf2.13305" target="_blank" >10.1002/ehf2.13305</a>

Result language

angličtina

Original language name

The effect of high-flow arteriovenous fistulas on systemic haemodynamics and brain oxygenation

Original language description

Aims: High-flow arteriovenous fistula (AVF) for haemodialysis leads to profound haemodynamic changes and sometimes to heart failure (HF). Cardiac output (CO) is divided between the AVF and body tissues. The term effective CO (COef) represents the difference between CO and AVF flow volume (Qa) and better characterizes the altered haemodynamics that may result in organ hypoxia. We investigated the effects of Qa reduction on systemic haemodynamics and on brain oxygenation. Methods and results: This is a single-centre interventional study. Twenty-six patients on chronic haemodialysis with high Qa (&gt;1500 mL/min) were indicated for surgical Qa reduction for HF symptoms and/or signs of structural heart disease on echocardiography. The included patients underwent three sets of examinations: at 4 months and then 2 days prior and 6 weeks post-surgical procedure. Clinical status, echocardiographical haemodynamic assessment, Qa, and brain oximetry were recorded. All parameters remained stable from selection to inclusion. After the procedure, Qa decreased from 3.0 +- 1.4 to 1.3 +- 0.5 L/min, P &lt; 0.00001, CO from 7.8 +- 1.9 to 6.6 +- 1.5 L/min, P = 0.0002, but COef increased from 4.6 +- 1.4 to 5.3 +- 1.4 L/min, P = 0.036. Brain tissue oxygen saturation increased from 56 +- 11% to 60 +- 9%, P = 0.001. Conclusions: Qa reduction led to increased COef. This was explained by a decreased proportion of CO running through the AVF in patients with Qa &gt; 2.0 L/min. These observations were mirrored by higher brain oxygenation and might explain HF symptoms and improved haemodynamics even in asymptomatic high Qa patients.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

<a href="/en/project/NV17-31796A" target="_blank" >NV17-31796A: Tissue hypoxia in patients with chronic kidney disease – metabolic and hemodynamic associations</a><br>

Continuities

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Publication year

2021

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

ESC Heart Failure [online]

ISSN

2055-5822

e-ISSN

—

Volume of the periodical

8

Issue of the periodical within the volume

3

Country of publishing house

GB - UNITED KINGDOM

Number of pages

7

Pages from-to

2165-2171

UT code for WoS article

000631526200001

EID of the result in the Scopus database

2-s2.0-85102875270