Cardiovascular manifestations in patients treated with periodic hemodialysis through functional arteriovenous fistula

Introduction: Cardiovascular manifestations produced by the arteriovenous fistula in patients treated with hemodialysis are an important aspect, as cardiovascular disease is the leading cause of morbidity and mortality. Objective: To determine the cardiovascular manifestations in patients with a functional arteriovenous fistula treated with regular hemodialysis. Method: Descriptive, transversal study, with 81 patients in dialysis treatment who had a functional arteriovenous fistula. Clinical records were reviewed, and a trans thoracic echocardiogram was carried out. Association between variables was determined by statistical tests. Results: There was a significant difference in the hemodialysis treatment time in patients with hypertrophic cardiomyopathy, 70% in less than 4 years against 100% in more than 4 years (p=0.03), valve diseases 67.4 vs. 94.3% (p=0.03), and pulmonary hypertension 26.1 vs. 57.1% (p=0.05); and also regarding the diameter of the left atrium 45.124.7 mm, less than 4 years, against 50.9+/-7.6 mm, more than 4 years (p=0.00). E' wave velocity 7.9+/-1.4 cm/s vs. 7.2+/-1.7 cm/s (p=0.045). Interventricular septum 16.4+/-3.1 mm vs. 18.5+/-4.9 mm (p=0.021), and posterior wall 14.6+/-2.5 vs. 16.5+/-3.1 mm (p=0.003); as well as mean pulmonary artery pressure 25.6+/-7.5 mmHg vs. 29.3+/-8.4 mmHg (p=0.042). Conclusions: No relationship was found between the fistula location and changes in the cardiovascular system. The group of patients with more than four years fistula presented major cardiovascular events and significant changes in the echocardiogram.