Right ventricular-pulmonary arterial coupling and pulmonary hypertension in hemodialysis: insights into structural cardiac changes and clinical implications
Rattachement africain : cz, nl, es, us, de. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Objectives This cross-sectional analysis from the CZecking Heart Failure in patients with advanced Chronic Kidney Disease trial (ISRCTN18275480) examined pulmonary hypertension and right ventricular-pulmonary arterial coupling in patients on chronic hemodialysis. The aims of this analysis were: 1. To analyze relations between pulmonary hypertension and right ventricular-pulmonary arterial coupling with dialysis access flow and current hydration; 2. To analyze structural heart changes associated with right ventricular-pulmonary arterial uncoupling; 3. To reveal the prevalence, etiology and severity of pulmonary hypertension in the Czech hemodialysis population.Methods We performed expert echocardiography, vascular access flow measurements, bioimpedance analysis, and laboratory testing in 336 hemodialysis patients.Results Pulmonary hypertension was present in 34% (114/336) patients and right ventricular-pulmonary arterial uncoupling was present in 25% of patients with pulmonary hypertension. Only weak associations between the flow of the dialysis arteriovenous access and estimated pulmonary arterial systolic pressure and right ventricular-pulmonary arterial coupling was proved. There was a strong association between hydration status assessed by estimated central venous pressure with pulmonary arterial systolic pressure (Rho 0.6, p < 0.0001) and right ventricular-pulmonary arterial coupling (Rho −0.52, p < 0.0001) and association between overhydration to extracellular water ratio with pulmonary arterial systolic pressure (Rho 0.31, p = 0.0001) and right ventricular-pulmonary arterial coupling (Rho −0.29, p = 0.002). The prevalence of heart failure was significantly higher in patients with right ventricular-pulmonary arterial uncoupling (88% vs. 52%, p = 0.0003).Conclusion These findings suggest that optimizing volume status and treating heart failure should be prioritized in hemodialysis patients to prevent pulmonary hypertension progression and right ventricular-pulmonary arterial uncoupling.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Right ventricular-pulmonary arterial coupling and pulmonary hypertension in hemodialysis: insights into structural cardiac changes and clinical implications
- Date Crossref
- 23/02/2025
- Éditeur
- Informa UK Limited
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Charles University pays non établi dans la noticeUniversité ou école supérieure
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B. Braun (Czechia) pays non établi dans la noticeEntreprise
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B. Braun (Netherlands) pays non établi dans la noticeEntreprise
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NephroCare pays non établi dans la noticeÉtablissement de santé
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Fresenius Medical Care North America (United States) pays non établi dans la noticeEntreprise
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Fresenius Kabi (Czechia) pays non établi dans la noticeEntreprise
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Fresenius Medical Care (Germany) pays non établi dans la noticeEntreprise
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General University Hospital and First Faculty of Medicine Third Department of Internal Medicine pays non établi dans la noticeUniversité ou école supérieure
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Dialysis Center Ohradni pays non établi dans la noticeInstitution
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Dialysis Center Cerny Most pays non établi dans la noticeInstitution
Charles University, B. Braun (Czechia) et B. Braun (Netherlands), avec 7 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.