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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Assessment of Vascular Function in Patients With Chronic Kidney Disease

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E/e' Ratio and Diastolic Function Between Deep Vein Catheterization and Internal Fistula Treatment in Patients with

Qiaoqiao Guo, Liyan Hu, Xiaoyang Qi

    Alternative Therapies in Health and Medicine
    |October 11, 2023
    PubMed

    Insights

    Internal fistula and deep vein catheterization improve uremic patients' diastolic function. Internal fistula offers superior reduction in left ventricular dimensions, though neither significantly impacts the E/e

    Area of Science:

    • Cardiology
    • Nephrology
    • Medical Imaging

    Background:

    • Chronic kidney disease (CKD) often leads to cardiovascular complications, including diastolic dysfunction.
    • Dialysis access methods, such as internal fistula and deep vein catheterization, may influence cardiac function in uremic patients.
    • The E/e' ratio is a key indicator of diastolic function, reflecting the early diastolic mitral inflow to early diastolic mitral annular velocity.

    Purpose of the Study:

    • To investigate the relationship between diastolic function and the E/e' ratio in patients with chronic renal disease undergoing different vascular access procedures.
    • To compare the effects of internal fistula versus deep vein catheterization on diastolic function and cardiac dimensions in uremic patients.

    Main Methods:

    • Retrospective analysis of clinical data from 50 uremia patients.
    • Patients were divided into two groups based on vascular access: internal fistula (n=42) and deep vein catheterization (n=8).
    • Echocardiographic parameters, including left ventricular dimensions and diastolic function indices (E/e'), were assessed before and after treatment.

    Main Results:

    • Both internal fistula and deep vein catheterization significantly reduced left ventricular end-diastolic diameter (LVd), E peak, A peak, E/A value, and ventricular volumes/areas post-treatment.
    • Internal fistula group showed significantly greater reductions in LVd, left ventricular end-systolic diameter (LVs), and ventricular volumes/areas compared to the deep vein catheterization group.
    • Neither treatment modality demonstrated a significant improvement in the E/e' ratio.

    Conclusions:

    • Both internal fistula and deep vein catheterization can ameliorate diastolic function and reduce pulmonary pressure in uremic patients.
    • Internal fistula appears more effective than deep vein catheterization in reducing left ventricular dimensions.
    • The impact of both access methods on improving the E/e' ratio in uremic patients is not significant.
    Abstract

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