Abstract
In order to clarify the chronic effects of arteriovenous (AV) fistula on the cardiac function of dialysis patients, we examined CAPD patients before, and one year after occlusion of their AV fistula.
Disused AV fistulas were occluded in 14 patients and another 14 sex-, age-, and duration of dialysis-matched patients retained their AV fistulas and served as controls.
Using M-mode echocardiography the following parameters were examined and calculated one year apart in the groups with and without the occlusion of their AV fistula: inter-ventricular septal thickness (IVS), left ventricular posterior wall thickness (PW), left ventricular end-diastolic dimension (LVDd), left ventricular end-systolic dimension (LVDs), left ventricular mass index (LVMI), cardiac index (CI), left ventricular ejection fraction (EF) and mean velocity of circumferential fiber shortening (mVcf). Heart rate (HR), systolic and diastolic blood pressure (sBP, dBP), cardiothoracic ratio (CTR), and hematocrit (Ht) were also determined.
None of the parameters changed significantly in the control group. On the other hand, LVDd and LVDs were reduced and EF and mVcf had improved in the group with fistula occlusion. CTR was also reduced in this group. When the patients with occluded fistulas were divided into two groups, a group with normal cardiac function with an EF of 50% or more before fistula occlusion, and a group with low cardiac function, CI was found to be reduced in the former, while EF and mVcf had improved and HR was reduced in the latter.
