Evolution of ultrasonic indices of the heart аnd arteriovenous fistulas in patients on chronic haemodialysis

Burleva E.P.¹, Nazarov A.V.², Popov A.N.³, Faskhiev R.R.³

1) Chair of General Surgery
2) Department of Anaesthesiology & Resuscitation Uralian State Medical Academy
3) Municipal Clinical Hospital No 40, Yekaterinburg, Russia

The authors assessed the ultrasonic evolution of haemodynamics of arteriovenous fistulas (AVFs), cardiohaemodynamics,and the dimensions of the heart chambers in a total of thirty-five patients presenting with terminal chronic renal insufficiency (TCRI) and being on chronic haemodialysis (CHD). A further thirteen patients without TCRI composed the control group. The TCRI patients were subdivided into two groups: Group One (n=20) with a distal variant of the Cimino-type AVF, 21 vascular accesses, and Group Two (n=15) with a proximal variant of AFV, 16 accesses using a synthetic vascular prosthesis (SVP). The terms of follow up of the TCRI patients were as follows: day 12, months 1, 3, 6 and 12 after creating the AVF. 12 days after creating the AVF there were no differences in the parameters of cardiohaemodynamics and the dimensions of the cardiac chambers between Group I and II. As compared with the control, the both groups of the patients with TCRI at these terms demonstrated increased sizes of the left ventricle (LV). The dynamic follow up during the subsequent periods showed that Group One and Group Two patients had no statistically significant differences in the parameters studied, however, patients of the both study groups were found to have a trend toward increased dimensions of the right chambers of the heart, not exceeding the limits of the norm of these indices. The volumetric velocity of the blood flow (BFVV) through the Cimino-type AVF during 12 months had a tendency towards a graduate growth up to 800 ml/min, whereas the proximal fistulas were characterized by stable indices of the BFVV at a level of 900 ml/min.

KEY WORDS: arteriovenous fistula, chronic haemodialysis, cardiac parameters, cardiohaemodynamics, volumetric velocity of the blood flow through a fistula.

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