{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:30:10Z","timestamp":1784867410970,"version":"3.55.0"},"reference-count":35,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004329","name":"Slovenian Research Agency","doi-asserted-by":"publisher","award":["P3-0323"],"award-info":[{"award-number":["P3-0323"]}],"id":[{"id":"10.13039\/501100004329","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Arteriovenous fistulas (AVFs) may contribute to cardiac remodeling and consequently to an increased risk of heart failure and cardiovascular mortality in patients with end-stage kidney disease (ESKD). We aimed to assess cardiac changes following AVF creation and identify potential parameters associated with cardiac remodeling. Methods: In our prospective, single-center study, ESKD patients without significant pre-existing cardiac disease underwent 2D and 3D echocardiographic evaluation before and after AVF creation, along with AVF flow measurement. Cardiac remodeling was assessed using 3D indexed left and right ventricular end-diastolic volumes (LVEDVi, RVEDVi), while systolic function was assessed using longitudinal strain and 3D ejection fraction. Results: We included 20 patients (18 men; median age 73.5 years [IQR: 67\u201377]) with a mean AVF flow of 1140 \u00b1 345 mL\/min. At a median of 8.2 months (IQR: 7.3\u20139.3) following AVF creation, significant biventricular dilatation was observed: LVEDVi increased from 89 \u00b1 14 to 97 \u00b1 21 mL\/m2 (p &lt; 0.05) and RVEDVi from 80 \u00b1 15 to 91 \u00b1 18 mL\/m2 (p &lt; 0.05), while the systolic function of both ventricles did not change significantly. The right ventricle showed the most pronounced remodeling and it was independently associated with volume overload (p = 0.003) and elevated left ventricular filling pressure (p = 0.030), but not with AVF flow. Conclusions: Moderate AVF flow was associated with cardiac remodeling, primarily affecting the right ventricle. Fluid overload and left ventricular filling pressure were key factors associated with right ventricular remodeling, underscoring the need for careful fluid management and vascular access planning in ESKD patients.<\/jats:p>","DOI":"10.3390\/jcm14155565","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T09:25:52Z","timestamp":1754558752000},"page":"5565","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Vascular Access for Hemodialysis and Right Ventricular Remodeling: A Prospective Echocardiographic Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Denis","family":"Fornazari\u010d","sequence":"first","affiliation":[{"name":"Department of Nephrology, University Medical Center Ljubljana, Zalo\u0161ka 2, 1000 Ljubljana, Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5394-3729","authenticated-orcid":false,"given":"Jakob","family":"Guben\u0161ek","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Medical Center Ljubljana, Zalo\u0161ka 2, 1000 Ljubljana, Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manja","family":"Antoni\u010d","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia"},{"name":"Department of Dialysis, General Hospital Trbovlje, Rudarska Cesta 9, 1420 Trbovlje, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2166-7720","authenticated-orcid":false,"given":"Marta","family":"Cviji\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia"},{"name":"Department of Cardiology, Ljubljana University Medical Centre, Zalo\u0161ka 2, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3265-8053","authenticated-orcid":false,"given":"Jernej","family":"Pajek","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Medical Center Ljubljana, Zalo\u0161ka 2, 1000 Ljubljana, Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1159\/000514550","article-title":"Global Epidemiology of End-Stage Kidney Disease and Disparities in Kidney Replacement Therapy","volume":"52","author":"Thurlow","year":"2021","journal-title":"Am. 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