Key result
Arteriovenous shunts drive significant hemodynamic changes and high-output heart failure despite limited HFpEF data.
Why the study?
Data on the haemodynamic impact of arteriovenous shunts focus mainly on heart failure with reduced ejection fraction, leaving limited data in heart failure with preserved ejection fraction.
Invasive assessment of the haemodynamic effects of arteriovenous shunts using right heart catheterization may provide valuable information in patients with HFpEF, an area where current data is limited and mostly non-invasive.
Answers are grounded in this paper and cite their sources.
Right heart catheterization may clarify shunt effects in HFpEF; leaves open whether routine invasive assessment improves outcomes.
The arteriovenous shunt (AVS) is the most commonly used vascular access in patients receiving regular haemodialysis. The AVS may have a significant haemodynamic impact on patients with heart failure. Many studies have sought to understand the effect of AVS creation or closure on heart structure and functions, most of which use non-invasive methods, such as echocardiography or cardiac MRI. Data are mainly focused on heart failure with reduced ejection fraction and there are limited data on heart failure with preserved ejection fraction. The presence of an AVS has a significant haemodynamic impact on the cardiovascular system and it is a common cause of high-output cardiac failure. Given that most studies to date use non-invasive methods, invasive assessment of the haemodynamic effects of the AVS using a right heart catheter may provide additional valuable information.
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Soliman et al. (2022) conducted a review in Heart failure with preserved ejection fraction. Arteriovenous shunts was evaluated. Arteriovenous shunts have a significant haemodynamic impact on the cardiovascular system and are a common cause of high-output cardiac failure, though data in patients with HFpEF remain limited.
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