title: Effect of upper arm brachial basilic and prosthetic forearm arteriovenous fistula on left ventricular hypertrophy.
abstract: BACKGROUND
  Creation of an arteriovenous fistula (AVF) may increase left ventricular hypertrophy in the hemodialysis population. Aim of this study was to compare the effects of a brachial-basilic (BB) AVF and the prosthetic brachial-antecubital forearm loop access (PTFE) on cardiac performance.
  
  
  METHODS
  Patients were randomized to receive BB-AVF or prosthetic brachial-antecubital forearm loop access. Before and three months after AVF creation patients underwent an echocardiographic examination. Mann-Whitney U-test was used to compare relative increase between the measured cardiac parameters for the two groups.
  
  
  RESULTS
  Twenty-seven patients participated in the study. The relative increase in left ventricular parameters was not significantly different between the two groups. Only left ventricular end-diastolic diameter tended to be of significance. Mean blood flow through the brachial artery was 1680+/-156 and 1450+/-221 mL/min three months after surgery for the PTFE and the BB-AVF group, respectively.
  
  
  CONCLUSIONS
  After three months of follow-up, changes in cardiac structure were comparable between patients with BB and PTFE AVFs. Also access flow was comparable at this time. In general, the effects of creation of a fistula on LV structure were limited. Longer follow up time may be needed to explore the long term effects of different vascular accesses on cardiac function.
authors.affiliation: Department of Surgery, University Hospital Maastricht , The Netherlands. xha.keuter@ah.unimaas.nl
authors.forename: X H A
authors.initials: XH
authors.lastname: Keuter
authors.forename: J P
authors.initials: JP
authors.lastname: Kooman
authors.forename: J
authors.initials: J
authors.lastname: Habets
authors.forename: F M
authors.initials: FM
authors.lastname: Van Der Sande
authors.forename: A G H
authors.initials: AG
authors.lastname: Kessels
authors.forename: E C
authors.initials: EC
authors.lastname: Cheriex
authors.forename: J H M
authors.initials: JH
authors.lastname: Tordoir
mesh_terms: D000368:Aged; D001132:Arm / Q000098:blood supply*; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005542:Forearm / Q000098:blood supply*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D006435:Renal Dialysis; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014680:Veins / Q000601:surgery; D016277:Ventricular Function, Left