Left ventricular growth after 1 year of haemodialysis does not correlate with arteriovenous access flow: a prospective cohort study.
BACKGROUND
The incidence of congestive heart failure is 3-fold greater than that of acute coronary syndrome in haemodialysis (HD) patients. The purpose of this study was to determine if blood flow through an arteriovenous (AV) access contributes to an increase in left ventricular mass (LVM) that may increase the risk of congestive heart failure.


METHODS
We conducted a 1-year prospective cohort study at two Canadian centres of HD patients at high risk for congestive heart failure who had a first AV access created. Patients underwent echocardiography and measurement of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels before and 1-year post-AV access creation. Access flows were measured within the first month of access maturation and 1-year post-access creation. Data were analysed using descriptive statistics, Student's t-test, correlation coefficients and regression.


RESULTS
One-year post-AV access creation, LVM increased by 12.2 +/- 32% (P = 0.025) and plasma NT-proBNP levels increased by 170 +/- 465% (P = 0.02). The average AV access blood flow did not correlate with an increase in LVM or NT-proBNP levels.


CONCLUSIONS
In patients on chronic HD after 1 year, AV access flow does not correlate with increases in LVM by echocardiography or plasma levels of NT-proBNP.
Hiremath
Swapnil
S
Division of Nephrology, Kidney Research Centre, Ottawa Health Research Institute, Ottawa, Ontario, Canada.
Doucette
Steve P
SP
Richardson
Robert
R
Chan
Kwan
K
Burns
Kevin
K
Zimmerman
Deborah
D
D000368:Aged; D001166:Arteriovenous Shunt, Surgical; D002170:Canada; D002908:Chronic Disease; D015331:Cohort Studies; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000502:physiology*; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D020257:Ventricular Remodeling
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain