Effects of arteriovenous fistula formation on arterial stiffness and cardiovascular performance and function
Effects of arteriovenous fistula formation on arterial stiffness and cardiovascular performance and function
复制标题
DOI：
10.1093/ndt/gfq851
复制
发表时间：
2011-10-01
影响因子：
6.1
通讯作者：
McIntyre, Christopher W.
中科院分区：
文献类型：
--
作者：
Korsheed, Shvan;Eldehni, Mohamed T.;McIntyre, Christopher W.
背景。天然动静脉瘘（AVF）是首选血管通路及其用途参见。导管与死亡率的持续降低有关。这可能是由于透析导管相关脓毒症以外的因素造成的。本研究旨在探讨 AVF 形成对心血管因素谱的影响，这些因素在慢性肾脏病 (CKD) 患者心血管疾病的病理生理学中可能很重要。方法。我们招募了 43 名接受 AVF 形成的透析前患者。患者在 AVF 手术前 2 周以及术后 2 周和 3 个月进行了研究。使用脉搏波分析测量血流动力学变量，通过压平眼压测量测量颈动脉脉搏波速度（CF-PWV），通过多普勒超声测量AVF血流。进行生物阻抗分析并对患者进行连续经胸超声心动图检查。结果。 30/43 的患者 AVF 成功形成。术后两周，总外周阻力下降（-17 +/- 18%，P = 0.001），每搏量趋于上升（12 +/- 30 mL，P = 0.053），心率（4 +/- 8 bpm，P = 0.01）和心输出量（1.1 +/- 1.5 L/min，P = 0.001）均增加。收缩压和舒张压 (BP) 降低（-9 +/- 18 mmHg；-9 +/- 10 mmHg；
Background. Native arteriovenous fistula (AVF) is the vascular access of choice and its use cf. catheters is associated with sustained reduction in mortality. This may be due to factors beyond dialysis catheter-associated sepsis. This study aimed to investigate the impact of AVF formation on the spectrum of cardiovascular factors that might be important in the pathophysiology of cardiovascular diseases in chronic kidney disease (CKD) patients.Methods. We recruited 43 pre-dialysis patients who underwent AVF formation. Patients were studied 2 weeks prior to AVF operation and 2 weeks and 3 months post-operatively. Haemodynamic variables were measured using pulse wave analysis, carotid femoral pulse wave velocity (CF-PWV) by applanation tonometry and AVF blood flow by Doppler ultrasound. Bioimpedence analysis was performed and patients underwent serial transthoracic echocardiography.Results. AVF formation was successful in 30/43 patients. Two weeks post-operatively, total peripheral resistance decreased (-17 +/- 18%, P = 0.001), stroke volume tended to rise (12 +/- 30 mL, P = 0.053) and both heart rate (4 +/- 8 bpm, P = 0.01) and cardiac output (1.1 +/- 1.5 L/min, P = 0.001) increased. Systolic and diastolic blood pressures (BPs) reduced (-9 +/- 18 mmHg; -9 +/- 10 mmHg;