| The influence of hemodialysis fistulas on circulatory dynamics and left ventricular function. | |
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MedLine Citation:
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PMID: 7095879 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This study was designed to examine the influence of arteriovenous (A-V) fistulas on cardiac output and left ventricular performance in 13 uremic patients on regular hemodialysis. M-mode echocardiography and systolic time intervals were used to derive indices of left ventricular function, and cardiac output was measured by thermodilution. Measurements were performed before and after acute digital occlusion of the A-V fistulas. Occlusion of a single fistula caused systemic vascular resistance and the systolic diameter of the left ventricle to increase from 9.6 +/- 1 to 13.5 +/- 2 units (p less than 0.001) and from 3.2 +/- .3 to 3.4 +/- .4 (p less than 0.05) respectively. The increase in afterload caused a reduction in cardiac output from 11.0 +/- 1 to 9.6 +/- 1 l/min (p less than 0.001) and probably accounted for the minor, though not significant, "deterioration" in the indices of left ventricular function. Bilateral fistula occlusion in 8 patients exaggerated these changes, and the reduction in fractional shortening from 43 +/- 4 to 37 +/- 4% was significant at the 5% level. In two patients with severe left ventricular failure, fistula occlusion caused a more pronounced deterioration in cardiac performance. These results show that acute A-V fistula occlusion effectively lowers cardiac output and is, therefore, likely to be beneficial in the management of high output failure. However, when intrinsic left ventricular disease is the primary etiological factor in heart failure, fistula occlusion is unlikely to be helpful, and may worsen the hemodynamic derangement. |
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Authors:
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A D Timmis; R J McGonigle; M J Weston; A A McLeod; G Jackson; D E Jewitt; V Parsons |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The International journal of artificial organs Volume: 5 ISSN: 0391-3988 ISO Abbreviation: Int J Artif Organs Publication Date: 1982 Mar |
Date Detail:
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Created Date: 1982-09-24 Completed Date: 1982-09-24 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7802649 Medline TA: Int J Artif Organs Country: ITALY |
Other Details:
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Languages: eng Pagination: 101-4 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Arm / blood supply Arteriovenous Shunt, Surgical / adverse effects* Cardiac Output* Female Heart Failure / physiopathology Hemodynamics* Humans Kidney / blood supply Male Middle Aged Renal Dialysis / adverse effects* Stroke Volume* Vascular Resistance |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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