Cardiovascular risk in myositis patients compared with the general population.

Objectives: We aimed to evaluate cardiovascular (CV) risk in patients with idiopathic inflammatory myopathies (IIM) compared with healthy controls (HC) and to assess its association with disease-specific features.

Methods: Ninety IIM patients and 180 age-/sex-matched HC were included. Subjects with a history of CV disease (angina pectoris, myocardial infarction and cerebrovascular/peripheral arterial vascular events) were excluded.

Cardiovascular Risk in Myositis Patients Compared to the General Population: Preliminary Data From a Single-Center Cross-Sectional Study.

Background: Idiopathic inflammatory myopathies (IIM) are associated with systemic inflammation, limited mobility, and glucocorticoid therapy, all of which can lead to metabolism disturbances, atherogenesis, and increased cardiovascular (CV) risk. The aim of this study was to assess the CV risk in IIM patients and healthy controls (HC), and its association with disease-specific features.

Methods: Thirty nine patients with IIM (32 females; mean age 56; mean disease duration 4.

Role of Doppler ultrasonography in the evaluation of hemodialysis arteriovenous access maturation and influencing factors.

The goal of vascular access creation is to achieve a functioning arteriovenous fistula (AVF) or arteriovenous graft (AVG). An autologous fistula has been shown to be superior to AVG or to central venous catheters (CVCs) with lowest rate of re-intervention, but vessel obstruction or immaturity accounts for 20 % to 54% of cases with primary failure of AVF. This review is focused on the factors influencing maturation; indication and timing of preoperative mapping/creation of vascular access; ultrasound parameters for creation AVF/AVG; early postoperative complications following creation of a vascular access; ultrasound determinants of fistula maturation and endovascular intervention in vascular access with maturation failure.

Hemodialysis vascular access affects heart function and outcomes: Tips for choosing the right access for the individual patient.

Chronic kidney disease is associated with increased cardiovascular morbidity and mortality. A well-functioning vascular access is associated with improved survival and among the available types of vascular access the arterio-venous (AV) fistula is the one associated with the best outcomes. However, AV access may affect heart function and, in some patients, could worsen the clinical status.

Treatment of failing arterio-venous dialysis graft by angioplasty, stent, and stent graft: Two-years analysis of patency rates and cost-effectiveness.

The objective of this prospective randomized single-center study was to compare primary and secondary patency rates, number of percutaneous transluminal angioplasty (PTA) interventions and cost-effectiveness among PTA, deployment of a stent, or a stent graft in the treatment of failing arteriovenous dialysis grafts (AVG) due to restenosis in the venous anastomosis or the outflow vein. Altogether 60 patients with failing AVG and restenosis in the venous anastomosis or the outflow vein were randomly assigned to either PTA, placement of a stent (E-Luminexx) or stent graft (Fluency Plus). After the procedure, patients with stent or stent graft received dual antiplatelet therapy for the next three months.

Factors influencing dialysis arteriovenous graft survival.

Purpose: Dysfunction and loss of patency of dialysis arteriovenous grafts (AVGs) are serious causes of morbidity in patients on dialysis. Various risk factors associated with shorter AVG patency have been blamed, but the results of the studies were controversial. The aim of this study was to assess if associated diseases, biochemical markers and other parameters associated with atherosclerosis influence patency of AVGs in a large vascular access centre.

Arteriovenous grafts: early ultrasonography tells their fortune.

Background: The patency of arteriovenous grafts (AVG) for hemodialysis is mostly limited by growing stenoses that lead to decreasing of blood flow, thromboses and finally to access failure. The aim of this study was to find out if detection of any pathology by duplex Doppler ultrasonography (DDU) early after creation of AVG could identify those with lower survival.

Methods: We retrospectively enrolled AVG examined by DDU in our center within 40 days after their creation during the last 10 years.

Long-term arterial adaptation to high blood flow in the feeding artery of vascular access for hemodialysis.

Purpose: Arteries continuously respond to changing tissue demands and to hemodynamic conditions by altering their diameter and wall structure. The relatively slow dilatation of the feeding artery of vascular accesses continues at least two years after access creation with a continuous decrease in wall shear rate (WSR), which however, remains highly supra-physiological. The aim of this study was to test the hypothesis that after a longer time period the WSR returns to its baseline value.

Low-flow polytetrafluoroethylene accesses: ultrasound surveillance and preemptive interventions ensure long-term patency.

Background: Vascular accesses (especially polytetrafluoroethylene grafts) with a permanently low flow (Qa <600 ml/min) are prone to thrombosis and thus have short patency. The reason for a permanently low flow is usually medial calcinosis of the inflow artery in diabetics. We retrospectively studied the long-term patency of low-flow grafts with careful ultrasound surveillance and preemptive interventions.

Short-term outcomes of borderline stenoses in vascular accesses with PTFE grafts.

Background: There are controversial data about vascular access stenosis surveillance by ultrasonography. The definition of stenosis significance varies among centres. We performed a retrospective study to describe short-term outcomes of borderline asymptomatic stenoses defined by precise criteria and to determine possible risk factors of stenosis progression.

Creation of dialysis vascular access with normal flow increases brain natriuretic peptide levels.

Background: Chronic heart failure is very common in hemodialyzed patients due to several factors such as intermittent volume overload, anemia, and hypertension. Dialysis access flow is usually considered to have a minor effect. We hypothesized that creation of dialysis access with "normal" flow would lead to elevation of B-type natriuretic peptide (BNP), which is a sensitive marker of heart failure.