Academic Journal
Association of Shear Stress with Subsequent Lumen Remodeling in Hemodialysis Arteriovenous Fistulas
| العنوان: | Association of Shear Stress with Subsequent Lumen Remodeling in Hemodialysis Arteriovenous Fistulas |
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| المؤلفون: | He, Yong, Shiu, Yan-Ting, Imrey, Peter B., Radeva, Milena K., Beck, Gerald J., Gassman, Jennifer J., Northrup, Hannah M., Roy-Chaudhury, Prabir, Berceli, Scott A., Cheung, Alfred K. |
| المصدر: | Clinical Journal of the American Society of Nephrology ; volume 18, issue 1, page 72-83 ; ISSN 1555-9041 1555-905X |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health) |
| سنة النشر: | 2023 |
| الوصف: | Background Blood flow-induced wall shear stress is a strong local regulator of vascular remodeling, but its effects on arteriovenous fistula (AVF) remodeling are unclear. Methods In this prospective cohort study, we used computational fluid dynamics simulations and statistical mixed-effects modeling to investigate the associations between wall shear stress and AVF remodeling in 120 participants undergoing AVF creation surgery. Postoperative magnetic resonance imaging data at 1 day, 6 weeks, and 6 months were used to derive current wall shear stress by computational fluid dynamic simulations and to quantify subsequent changes in AVF lumen cross-sectional area at 1-mm intervals along the proximal artery and AVF vein. Results Combining artery and vein data, prior mean wall shear stress was significantly associated with lumen area expansion. Mean wall shear stress at day 1 was significantly associated with change in lumen area from day 1 to week 6 (11% larger area per interquartile range [IQR] higher mean wall shear stress, 95% confidence interval [95% CI], 5% to 18%; n =101), and mean wall shear stress at 6 weeks was significantly associated with change in lumen area from 6 weeks to month 6 (14% larger area per IQR higher, 95% CI, 3% to 28%; n =52). The association of mean wall shear stress at day 1 with lumen area expansion from day 1 to week 6 differed significantly by diabetes ( P =0.009): 27% (95% CI, 17% to 37%) larger area per IQR higher mean wall shear stress without diabetes and 9% (95% CI, −1% to 19%) with diabetes. Oscillatory shear index at day 1 was significantly associated with change in lumen area from day 1 to week 6 (5% smaller area per IQR higher oscillatory shear index, 95% CI, 3% to 7%), and oscillatory shear index at 6 weeks was significantly associated with change in lumen from 6 weeks to month 6 (7% smaller area per IQR higher oscillatory shear index, 95% CI, 2% to 11%). Wall shear stress spatial gradient was not significantly associated with subsequent remodeling. In a joint model, wall shear ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.2215/cjn.04630422 |
| DOI: | 10.2215/CJN.04630422 |
| الاتاحة: | http://dx.doi.org/10.2215/cjn.04630422 https://journals.lww.com/10.2215/CJN.04630422 |
| رقم الانضمام: | edsbas.CFE8F908 |
| قاعدة البيانات: | BASE |
| DOI: | 10.2215/cjn.04630422 |
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