Improvement of the left atrial systolic function after a surgical reduction of the high flow arteriovenous fistula

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F25%3A00086266" target="_blank" >RIV/00023001:_____/25:00086266 - isvavai.cz</a>

Výsledek na webu

<a href="https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1732862/full" target="_blank" >https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1732862/full</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.3389/fmed.2025.1732862" target="_blank" >10.3389/fmed.2025.1732862</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Improvement of the left atrial systolic function after a surgical reduction of the high flow arteriovenous fistula

Popis výsledku v původním jazyce

Background: High-output heart failure (HOHF) is a distinct cardiac complication in end-stage kidney disease (ESKD) patients with high-flow arteriovenous fistulae (AVFs). While AVF flow reduction improves hemodynamics and left atrial (LA) volume, its effect on LA systolic function remains unclear. Objective: To evaluate changes in left atrial systolic function and left ventricular (LV) filling pressures following surgical AVF flow reduction in haemodialysis patients with high-flow fistulae. Methods: In this prospective, single-centre interventional study, 28 ESKD patients (mean age 63 +/- 15 years) with high-flow AVFs (&gt;1,500 mL/min) and clinical heart failure (NYHA &gt;= II) underwent surgical AVF flow reduction. Echocardiographic assessments were performed before and 6 weeks after intervention. LA ejection fraction (LAEF) and LV filling pressures (E/e &apos; ratio) were determined from digitally stored imaging data. Results: Surgical intervention reduced AVF flow by approximately 50% [2,525 [1,388] to 1,250 [700] mL/min, p = 0.00006]. LA volume index decreased significantly (44.7 +/- 17.3 to 38.5 +/- 15.4 mL/m(2), p = 0.01), accompanied by an improvement in LAEF (49.6 +/- 14.9% to 53.2 +/- 13.5%, p = 0.046). Dyspnoea improved or resolved in all patients. Baseline LAEF correlated negatively with age, LA volume index, and NYHA class, but no independent predictors of post-operative LAEF improvement were identified. Conclusions: In patients with high-flow AVF-associated HOHF, surgical AVF flow reduction leads to a significant improvement in LA systolic function alongside decreased LA volume. These findings suggest partial reversibility of atrial remodeling induced by chronic hyperkinetic circulation and highlight the potential cardiovascular benefits of AVF flow optimization in selected dialysis patients.

Název v anglickém jazyce

Improvement of the left atrial systolic function after a surgical reduction of the high flow arteriovenous fistula

Popis výsledku anglicky

Background: High-output heart failure (HOHF) is a distinct cardiac complication in end-stage kidney disease (ESKD) patients with high-flow arteriovenous fistulae (AVFs). While AVF flow reduction improves hemodynamics and left atrial (LA) volume, its effect on LA systolic function remains unclear. Objective: To evaluate changes in left atrial systolic function and left ventricular (LV) filling pressures following surgical AVF flow reduction in haemodialysis patients with high-flow fistulae. Methods: In this prospective, single-centre interventional study, 28 ESKD patients (mean age 63 +/- 15 years) with high-flow AVFs (&gt;1,500 mL/min) and clinical heart failure (NYHA &gt;= II) underwent surgical AVF flow reduction. Echocardiographic assessments were performed before and 6 weeks after intervention. LA ejection fraction (LAEF) and LV filling pressures (E/e &apos; ratio) were determined from digitally stored imaging data. Results: Surgical intervention reduced AVF flow by approximately 50% [2,525 [1,388] to 1,250 [700] mL/min, p = 0.00006]. LA volume index decreased significantly (44.7 +/- 17.3 to 38.5 +/- 15.4 mL/m(2), p = 0.01), accompanied by an improvement in LAEF (49.6 +/- 14.9% to 53.2 +/- 13.5%, p = 0.046). Dyspnoea improved or resolved in all patients. Baseline LAEF correlated negatively with age, LA volume index, and NYHA class, but no independent predictors of post-operative LAEF improvement were identified. Conclusions: In patients with high-flow AVF-associated HOHF, surgical AVF flow reduction leads to a significant improvement in LA systolic function alongside decreased LA volume. These findings suggest partial reversibility of atrial remodeling induced by chronic hyperkinetic circulation and highlight the potential cardiovascular benefits of AVF flow optimization in selected dialysis patients.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

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OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

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Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2025

Kód důvěrnosti údajů

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

Název periodika

Frontiers in medicine [online]

ISSN

2296-858X

e-ISSN

2296-858X

Svazek periodika

12

Číslo periodika v rámci svazku

December 2025

Stát vydavatele periodika

CH - Švýcarská konfederace

Počet stran výsledku

5

Strana od-do

"art. no. 1732862"

Kód UT WoS článku

001668537200001

EID výsledku v databázi Scopus

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