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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Shunt flow of arteriovenous fistula (AVF) is known to pose a risk of high-output heart failure due to excessive increases in cardiac output and decreased vascular resistance. Previous reports indicate that AVF blood flow (Qa) > 2.0 L/min constitutes excessive flow, clearly posing a risk of heart failure. Even without excessive flow, shunt circulation can cause compensatory right ventricular hypertrophy due to increased right ventricular preload from sustained elevated venous return. Furthermore, as the condition progresses, left ventricular preload can lead to left ventricular hypertrophy and diastolic dysfunction, resulting in a risk of fatal heart failure. In recent years, vascular access is adjusted according to cardiac function. As a result, excessive flow AVFs that affect cardiac output, as described above, have decreased. At our hospital, all patients are managed with Qa < 2.0 L/min. However, long-term observational studies on cardiac function changes due to non-excessive blood flow AVFs are scarce. This study examined the relationship between changes in right ventricular load findings at 5 years post-initiation of dialysis and AVF blood flow in our hospital's hemodialysis patients.
This study targets hemodialysis patients who underwent initiation of dialysis at our hospital and received maintenance dialysis management for five years or more. Brachial artery blood flow was measured using pulse Doppler ultrasound, and its correlation with the frequency of congestive heart failure during the course of the disease was evaluated. Right ventricular overload findings on transthoracic echocardiography at initiation were compared with those at 5 years post-initiation.
49 cases were followed up for 5 years at our institution from the initiation of dialysis, with a median Qa is 850 (IQR 639-1192) ml/min. During follow-up, 17 cases developed NYHA Class II or higher heart failure (4 cases due to acute coronary syndrome, 13 cases due to congestive heart failure caused by fluid overload). Logistic regression analysis, with heart failure onset as the dependent variable and Qa as the explanatory variable, revealed a significant correlation between Qa and heart failure onset (p-value 0.048). Similarly, comparing changes in right ventricular load parameters measured by echocardiography—tricuspid regurgitation velocity (TRV), estimated right ventricular pressure (RVP), left atrial volume index (LAVI), and E/e' showed no correlation with AVF perfusion. The changes in ΔTRV (p=0.36), ΔRVP (p=0.83), ΔLAVI (p=0.15), ΔE/e' (p-value 0.28), none showed a correlation with Qa.
Even when Qa is appropriately controlled and adequate fluid correction is performed, an increase in Qa may elevate the risk of congestive heart failure. Conversely, shunt perfusion of AVF may not be associated with right ventricular load risk over the short-term course of 5 years. Each case should be evaluated and reported considering its specific characteristics, fluid volume assessment, other cardiac function, and findings of cardiac load.
