Echocardiographic detection of cardiac effects of arterio-venous dialysis fistula.

Abstract

The effects of the dialysis fistula were evaluated by echocardiography in 10 patients with terminal renal failure. Echocardiography was performed the day before creation of the fistula (E0) and was then repeated 24 hours after surgery (E1), the day before the first dialysis (E2), the day following the fourth dialysis (E3) and, finally, after 6 months of RDT (E4). Left ventricular internal diameter was measured both in diastole (LVIDd) and in systole (LVIDs), allowing calculation of ventricular diameter percent shortening (LVID%), of ventricular diastolic (EDV) and systolic volume (ESV). In E1 the fistula caused a significant increase in LVIDd, accounting for a rise also in EDV. This ventricular dilation persisted in E2, but was abolished in E3 and in E4. LVIDs, ESV, and LVID% were unmodified throughout the study. these results show that the dialysis fistula causes an immediate rise in cardiac pre-load, which is rapidly reversed by RDT.