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2020, Number 3

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Rev cubana med 2020; 59 (3)

Hemodynamic impact of arteriovenous fistula closure on the right heart in kidney transplant patients

Cruz ARE, Ramírez GJI, González CY, Hernández FME, Hernández POA, Batista HR

Language: Spanish
References: 24
Page: 1-10
PDF size: 371.97 Kb.


ABSTRACT

Introduction: Cardiovascular complications are the leading cause of morbidity and mortality in kidney transplant recipients.
Objective: To describe the consequence of arteriovenous fistula on hemodynamic variables of the right heart in kidney transplantation.
Methods: We conducted a prospective, longitudinal study. Fifty two patients were included, and they were clinically and echocardiographically assessed. Five hemodynamic variables were compared in the right heart, prior to the closure of the arteriovenous fistula and six months after.
Results: The average age was 46.02 years, 29 were male (55.8%). The diameter decreased in the right atrium in closed fistulas in the left wrist ≥ 6 years (p = 0.044). The same occurred in the right ventricle <6 years at the level of the left elbow crease (p = 0.004). The systolic pressure of the pulmonary artery decreased after closure in the left elbow <6 years (p = 0.002), in ≥6 (p = 0.05) and in the right (p = 0.006). The mean pressure of the pulmonary artery was reduced in those closed in the crease of the left elbow <6 years (p = 0.001) and ≥6 years (p = 0.017) as well as in the right (p = 0.009). The right ventricular ejection fraction increased at closure in the left wrist <6 years (p = 0.046) and in the right elbow ≥6 years (p = 0.027).
Conclusions: The permanence of arteriovenous fistula in the kidney transplant recipient contributes to the perpetuation and progression of the pre-existing cardiovascular dysfunction.


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