Heart failure & cardiomyopathies
Systemic Vascular Resistance Predicts High-Output Cardiac Failure in Patients with High-Flow Arteriovenous Fistula
Main finding · HOCF hospitalizationResult — go to the resultHazard ratio 9.084 95% CI 2.33–35.39Authors' conclusion
In patients with high-flow AV access, low eSVR values obtained through non-invasive Doppler echocardiography were associated with a high rate of HOCF hospitalizations.
Study context
- Population
- Patients with high-flow arteriovenous (AV) access who underwent serial echocardiography
- Participants
- 109 patients
- Exposure
- High-output cardiac failure (HOCF) hospitalization vs no HOCF hospitalization
- HOCFn = 19
- Outcome
- Hospitalization due to high-output cardiac failure (HOCF)
- Follow-up
- Mean 25.1 months
Methodological detailsage- and gender-matched
- Age- and gender-matched
Main finding
HOCF hospitalization
Hazard ratio
9.084
95% CI 2.33–35.39
P = 0.001
HOCF hospitalization vs no HOCF hospitalization
HR 9.084 (95% CI 2.33–35.39); P = 0.001
As reported in the abstract
- Hospitalized due to HOCF
- 19 (17.4%)
Observational data: associations, not effects.
Further findings
Vascular access blood flow (Qa)
P = 0.045
| Outcome | HOCF | Non-HOCF | P value |
|---|---|---|---|
| E/e' (LV diastolic dysfunction) | 21.1 ± 7.3 | 16.2 ± 5.9 | P = 0.002 |
| RV systolic pressure (pulmonary hypertension) | 41.4 ± 16.7 | 32.2 ± 12.8 | P = 0.009 |
| Doppler-derived cardiac index | 4.3 ± 0.8 | 3.7 ± 1.1 | P = 0.031 |
| Doppler-derived estimated SVR (eSVR) | 5.5 ± 0.3 | 6.9 ± 0.2 | P = 0.002 |
- Prediction of HOCF hospitalization (ROC): CI/estimated SVR (eSVR) sensitivity 94.7% · specificity 51.0% · AUC 0.75 · P P < 0.001
- Prediction of HOCF hospitalization (ROC): Qa/cardiac output ratio AUC 0.50 · P P = 0.955
- Prediction of HOCF hospitalization (ROC): Qa ≥ 2000 mL/min AUC 0.60 · P P = 0.181
- Prediction of HOCF hospitalization (ROC): Qa indexed for height AUC 0.65 · P P = 0.040
Original publication
Systemic Vascular Resistance Predicts High-Output Cardiac Failure in Patients with High-Flow Arteriovenous Fistula. ESC Heart Fail. Published 26 October 2023. doi:10.
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