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A Murine Model of Hemodialysis Access-Related Hand Dysfunction
Published on: May 31, 2022
Right ventricular diastolic function in dialysis patients could be affected by vascular access
Luca Di Lullo1, Fulvio Floccari, Pasquale Polito
1Unit of Nephrology and Dialysis, S. Giovanni Evangelista Hospital, Tivoli, Italy.
Nephron. Clinical Practice
|January 4, 2011
Summary
Hemodialysis (HD) reduces heart function, particularly Tricuspid Annular Plane Excursion (TAPSE), indicating diastolic dysfunction. Arteriovenous fistula (AVF) access worsens right ventricle function compared to central venous catheters (CVC).
Area of Science:
- Cardiology
- Nephrology
- Echocardiography
Background:
- Tricuspid annular plane excursion (TAPSE) reflects diastolic distensibility and predicts cardiac mortality.
- Congestive heart failure patients benefit from TAPSE in prognostic assessment.
- Terminal uremia impacts right ventricle function.
Purpose of the Study:
- To evaluate the effect of a single hemodialysis (HD) session on diastolic function and TAPSE.
- To investigate the influence of vascular access typology (arteriovenous fistula vs. central venous catheter) on these changes.
Main Methods:
- Twenty chronically uremic patients underwent echocardiography before and after HD.
- Patients were divided into two groups: 10 with distal radiocephalic AVF and 10 with CVC.
- Measurements included TAPSE, ventricular volumes, and Doppler-derived diastolic parameters.
Main Results:
- HD significantly reduced TAPSE, ventricular volumes, and diastolic function parameters.
- Patients with AVF exhibited larger right ventricle diameters and lower TAPSE compared to CVC patients.
- AVF patients were the only group with TAPSE values below 15 mm.
Conclusions:
- Hemodialysis impairs right ventricle diastolic function and reduces TAPSE.
- Arteriovenous fistula access is associated with greater right ventricle abnormalities than central venous catheters.
- Increased preload from AVF may explain the observed functional changes.
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