Arteriovenous fistulae and cardiovascular function: the relationship between brain naturetic peptide, cardiac index and access flow

By Emma Aitken and David K

The Vascular Access Society defines “highflow” AVF as those with Qa>1000–1500mL/ min [1]. High vascular access blood flow (Qa) is believed to increase cardiac output and may lead to high output cardiac failure [2]. There is anecdotal evidence that high flow arteriovenous fistulae (AVF) can cause symptomatic heart failure with dyspnea, orthopnoea, paroxysmal nocturnal dyspnea and peripheral oedema [2,3]. However there is little evidence in the literature attempting to quantify the cardiovascular effects of an arteriovenous fistula. Several years ago, Suttie and colleagues (2012) measured BNP in patients with maturing de novo AVF finding no effect on brain naturetic peptide (BNP) levels [4].

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