ID | 53742 |
Sort Key | 6
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タイトル(別表記) | Non-high-output cardiac failure in patients undergoing hemodialysis through an arteriovenous shunt
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フルテキストURL | |
著者 | |
抄録 | Background: Hemodialysis-related heart failure has been considered to be associated with excessive blood flow through the arteriovenous (AV) shunt used for vascular access. However, some patients undergoing dialysis have heart failure in the absence of an increase in cardiac output (CO) related to shunt blood-flow loading because the loading cannot be compensated for by increasing CO. This condition may be challenging to manage ; thus, early diagnosis is important.
Methods and Results: Twelve patients (mean age, 71 years ; 9 men) with end-stage renal disease, dialysis-related heart failure, a high brain natriuretic peptide (BNP) level, and a mean New York Heart Association (NYHA) class of II underwent AV shunt closure. Their cardiac index (CI), pre- and post-dialysis BNP levels, and several cardiac variables were assessed pre- and postoperatively. All patients achieved relief of heart failure symptoms and a reduction in NYHA class after AV closure, but six patients had a postoperative increase in CI (the "non-high-output" cardiac failure group), whereas the other six had a decrease in CI (the "high-output" cardiac failure group). The high-output patients had greater improvements in BNP levels and most cardiac variables compared to the non-high-output group ;
therefore, the heart failure in the non-high-output patients was considered more serious than that in the high-output group.
Conclusions: The selection of effective strategies for treating dialysis-related heart failure may depend partly on identifying which patients have non-high-output failure. Such identification requires serial measurements of BNP levels and evaluations of cardiac variables other than the ejection fraction.
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キーワード | 心拍出量(cardiac output)
心不全(heart failure)
脳性ナトリウム利尿ペプチド(brain natriuretic peptide)
非過大シャント心不全(non-high-output cardiac failure)
腎臓(kidney)
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備考 | 原著 (Original Paper)
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出版物タイトル |
岡山医学会雑誌
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発行日 | 2015-12-01
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巻 | 127巻
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号 | 3号
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出版者 | 岡山医学会
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出版者(別表記) | Okayama Medical Association
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開始ページ | 203
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終了ページ | 207
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ISSN | 0030-1558
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NCID | AN00032489
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資料タイプ |
学術雑誌論文
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関連URL | isVersionOf https://doi.org/10.4044/joma.127.203
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OAI-PMH Set |
岡山大学
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言語 |
日本語
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著作権者 | Copyright (c) 2015 岡山医学会
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論文のバージョン | publisher
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査読 |
有り
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DOI | |
NAID | |
Eprints Journal Name | joma
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