{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:03:55Z","timestamp":1789167835332,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T00:00:00Z","timestamp":1702944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>An arteriovenous fistula (AVF) in patients with end\u2010stage kidney disease (ESKD) can influence flow states. We sought to evaluate if assessment of aortic stenosis (AS) by transthoracic echocardiographic (TTE) differs in the presence of AVF compared to other dialysis accesses in patients on dialysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified consecutive ESKD patients on dialysis and concomitant AS from a single center between January 2000 and March 2021. We analyzed TTE parameters of AS severity (velocities, gradients, aortic valve area [AVA]) and hemodynamics (cardiac output [CO], valvuloarterial impedance [Zva]) and compared AS parameters in patients with AVF versus other dialysis access.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cohort included 94 patients with co\u2010prevalent ESKD and AS; mean age 66\u00a0years, 71% male; 43% Black, 24% severe AS. Dialysis access: 53% AVF, 47% others. In the overall cohort, no significant differences were noted between AVF versus non\u2010AVF in AVA\/CO\/Zva, but with notable subgroup differences. In mild AS, CO was significantly higher in AVF versus non\u2010AVF (6.3 vs. 5.2\u00a0L\/min; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.04). In severe AS, Zva was higher in the AVF versus non\u2010AVF (4.6 vs. 3.6\u00a0mm Hg\/mL\/m<jats:sup>2<\/jats:sup>). With increasing AS severity in the AVF group, CO decreased, coupled with increase in Zva, likely counterbalancing the net hemodynamic impact of the AVF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among ESKD patients with AS, TTE parameters of flow states and AS severity differed in those with AVF versus other dialysis accesses and varied with progression in severity of AS. Future longitudinal assessment of hemodynamic parameters in a larger cohort of co\u2010prevalent ESRD and AS would be valuable.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15728","type":"journal-article","created":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T19:15:27Z","timestamp":1703013327000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Impact of arteriovenous fistula on flow states in the evaluation of aortic stenosis among ESKD patients on dialysis"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1800-8022","authenticated-orcid":false,"given":"Fredrick M.","family":"Ogugua","sequence":"first","affiliation":[{"name":"Division of Cardiology University of Illinois Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy O.","family":"Mathew","sequence":"additional","affiliation":[{"name":"Division of Cardiology Loma Linda VA Health Care System Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Ternacle","sequence":"additional","affiliation":[{"name":"Division of Cardiology H\u00f4pital Cardiologique Haut\u2010L\u00e9v\u00eaque, CHU de Bordeaux Pessac France"},{"name":"Division of Cardiology Qu\u00e9bec Heart and Lung Institute, Laval University Qu\u00e9bec City Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"Rodin","sequence":"additional","affiliation":[{"name":"Division of Biostatistics Hennepin Healthcare Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Pibarot","sequence":"additional","affiliation":[{"name":"Division of Cardiology Qu\u00e9bec Heart and Lung Institute, Laval University Qu\u00e9bec City Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7614-9560","authenticated-orcid":false,"given":"Gautam R.","family":"Shroff","sequence":"additional","affiliation":[{"name":"Division of Biostatistics Hennepin Healthcare Minneapolis Minnesota USA"},{"name":"Division of Cardiology, Department of Internal Medicine Hennepin Healthcare Minneapolis Minnesota USA"},{"name":"Division of Cardiology University of Minnesota Medical School  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,19]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"RitzE ErardG\u00b4 LondonM PannierB MarchaisSJ GuerinAP.Disease of the month calcification of the aortic valve in the dialyzed patient;2000."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gft310"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000071280"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-15316-6"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfq596"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01140211"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.004961"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.120.009252"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx391"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000979"},{"issue":"26","key":"e_1_2_8_12_1","article-title":"Aortic valve stenosis: evaluation and management of patients with discordant grading","volume":"15","author":"Messika\u2010Zeitoun D","year":"2018","journal-title":"Eur Soc Cardiol"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.06.025"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2017.02.009"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.12248"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ehj.2018.10.007"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.04.079"},{"key":"e_1_2_8_18_1","first-page":"E72","article-title":"2020 ACC\/AHA guideline for the management of patients with valvular heart disease: a Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"143","author":"Otto CM","year":"2021","journal-title":"Circulation"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2020.02.018"},{"key":"e_1_2_8_20_1","unstructured":"R: The R Project for Statistical Computing [Internet]. 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