About: Long-term arterial adaptation to high blood flow in the feeding artery of vascular access for hemodialysis     Goto   Sponge   NotDistinct   Permalink

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Description
  • Arteries continuously respond to changing tissue demands and to hemodynamic conditions by altering their diameter and wall structure. The relatively slow dilatation of the feeding artery of vascular accesses continues at least two years after access creation with a continuous decrease in wall shear rate (WSR), which however, remains highly supra-physiological. The aim of this study was to test the hypothesis that after a longer time period the WSR returns to its baseline value. Methods: In a cross-sectional study patients with arteriovenous fistulae were classified into four groups according to the access vintage (from new access to accesses older than six years). The WSR, cross-sectional area, and mean circumferential wall stress were measured and compared between groups. Results: WSR decreased from group 1 (fistula < ninety days old) to group 4 (fistulae > six years old) with a concomitant increase in internal diameter. Patients with the oldest access had normal WSR values (compared to the contralateral brachial artery) and the largest internal diameter of the feeding artery. In diabetic patients the absolute values of WSR were higher and internal diameter was lower compared to nondiabetic patients. Conclusions: Brachial artery WSR is normal in accesses older than six years with an increased internal diameter and wall cross-sectional area as compared to %22younger%22 accesses. This suggests a process of vascular remodeling with an increase in vascular wall mass and normalization of WSR to physiologic values at the price of increased mean cross-sectional wall stress.
  • Arteries continuously respond to changing tissue demands and to hemodynamic conditions by altering their diameter and wall structure. The relatively slow dilatation of the feeding artery of vascular accesses continues at least two years after access creation with a continuous decrease in wall shear rate (WSR), which however, remains highly supra-physiological. The aim of this study was to test the hypothesis that after a longer time period the WSR returns to its baseline value. Methods: In a cross-sectional study patients with arteriovenous fistulae were classified into four groups according to the access vintage (from new access to accesses older than six years). The WSR, cross-sectional area, and mean circumferential wall stress were measured and compared between groups. Results: WSR decreased from group 1 (fistula < ninety days old) to group 4 (fistulae > six years old) with a concomitant increase in internal diameter. Patients with the oldest access had normal WSR values (compared to the contralateral brachial artery) and the largest internal diameter of the feeding artery. In diabetic patients the absolute values of WSR were higher and internal diameter was lower compared to nondiabetic patients. Conclusions: Brachial artery WSR is normal in accesses older than six years with an increased internal diameter and wall cross-sectional area as compared to %22younger%22 accesses. This suggests a process of vascular remodeling with an increase in vascular wall mass and normalization of WSR to physiologic values at the price of increased mean cross-sectional wall stress. (en)
Title
  • Long-term arterial adaptation to high blood flow in the feeding artery of vascular access for hemodialysis
  • Long-term arterial adaptation to high blood flow in the feeding artery of vascular access for hemodialysis (en)
skos:prefLabel
  • Long-term arterial adaptation to high blood flow in the feeding artery of vascular access for hemodialysis
  • Long-term arterial adaptation to high blood flow in the feeding artery of vascular access for hemodialysis (en)
skos:notation
  • RIV/00064165:_____/12:12440!RIV13-MZ0-00064165
http://linked.open...avai/predkladatel
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • I, P(NS10590)
http://linked.open...iv/cisloPeriodika
  • 3
http://linked.open...vai/riv/dodaniDat
http://linked.open...aciTvurceVysledku
http://linked.open.../riv/druhVysledku
http://linked.open...iv/duvernostUdaju
http://linked.open...titaPredkladatele
http://linked.open...dnocenehoVysledku
  • 147422
http://linked.open...ai/riv/idVysledku
  • RIV/00064165:_____/12:12440
http://linked.open...riv/jazykVysledku
http://linked.open.../riv/klicovaSlova
  • Arterial remodeling; hemodialysis; vascular access; wall shear rate; wall shear-stress (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • IT - Italská republika
http://linked.open...ontrolniKodProRIV
  • [577CBA3B3688]
http://linked.open...i/riv/nazevZdroje
  • Journal of Vascular Access
http://linked.open...in/vavai/riv/obor
http://linked.open...ichTvurcuVysledku
http://linked.open...cetTvurcuVysledku
http://linked.open...vavai/riv/projekt
http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 13
http://linked.open...iv/tvurceVysledku
  • Chytilová, Eva
  • Kudlička, Jaroslav
  • Malík, Jan
  • Tuka, Vladimír
  • Slavíková, Marcela
  • Tordoir, Jan, H.M.
  • Wijnen, Edwin
  • van Hooland, Simon
http://linked.open...ain/vavai/riv/wos
  • 000310197200008
issn
  • 1129-7298
number of pages
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