Randomized trial of bioelectrical impedance analysis versus clinical criteria for guiding ultrafiltration in hemodialysis patients: effects on blood pressure, hydration status, and arterial stiffness.

Background: Chronic fluid overload is common in maintenance hemodialysis (HD) patients and is associated with severe cardiovascular complications, such as arterial hypertension, left ventricular hypertrophy, congestive heart failure, and arrhythmia. Therefore, a crucial target of HD is to achieve the so-called dry weight; however, the best way to assess fluid status and dry weight is still unclear. Dry weight is currently determined in most dialysis units on a clinical basis, and it is commonly defined as the lowest body weight a patient can tolerate without developing intra-dialytic or inter-dialytic hypotension or other symptoms of dehydration.

Regression of left ventricular hypertrophy in hemodialyzed patients is possible: a follow-up study.

Background: Few studies have addressed the description of serial changes in left ventricular mass (LVM) and relevant risk factors. The aims of our study were to describe trends in left ventricular (LV) structure and function derived from echocardiographic measurements over a 10-year period in Fresenius Nephrocare Dialysis Center in Iaşi and to compare the results with those obtained on a smaller group 4 years ago.

Methods: Three hundred and thirty-four hemodialyzed patients were enrolled at baseline, between January 1999 and March 2009.

The relationship between chronic volume overload and elevated blood pressure in hemodialysis patients: use of bioimpedance provides a different perspective from echocardiography and biomarker methodologies.

Background: Chronic volume overload is very frequent in hemodialysis (HD) patients and is directly associated with hypertension, increased arterial stiffness, left ventricular hypertrophy (LVH), heart failure and ultimately with higher mortality and morbidity. One major issue is that presently there are very few comparative studies of the various methods (clinical, bioimpedance, inferior cava vein diameter (ICV) and Brain Natriuretic Peptide (NT-proBNP)) for volume status evaluation and their correlation with cardiovascular disease.

Methods: In 160 patients treated by chronic HD in our center, euvolemic according to clinical assessment, we performed evaluation of volume status through bioimpedance spectroscopy (BIS), ICV and NT-proBNP, as well as echocardiography, to estimate the left ventricle structure and function.

Infective endocarditis--a forgotten cause for heart insufficiency in elderly. Case report.

Right heart infective endocarditis in an elderly patient with no previous known risk factors is a very rare situation (even if subacute infective endocarditis has the same chance of occurrence at either a young person, or an elderly patient). We present the case of a 75-years old patient, with no previous cardiac history, addressed to our clinic with nonspecific septic symptoms associated with an edematous syndrome. The patient was treated for right heart valve infective endocarditis; a particularity may be the fact not all Duke criteria were respected.

[Pulse pressure, arterial compliance and Buckberg index in hypertensive patients treated with nebivolol and nitrates].

Objective: To evaluate the effect of nebivolol and nitrate administration on the arterial compliance--an essential factor for left ventricular hypertrophy regression.

Material And Method: The arterial compliance was assessed in 32 hypertensive patients (mean age 52.3 years +/- 11, M/F ratio = 26/6) before drug administration, three hour post oral intake of nebivolol 5 mg and five minutes after sublingual 0.