The Potential of Sound Analysis to Reveal Hemodynamic Conditions of Arteriovenous Fistulae for Hemodialysis.

IF 3 2区 医学 Q3 ENGINEERING, BIOMEDICAL
Sofia Poloni, Luca Soliveri, Anna Caroli, Andrea Remuzzi, Michela Bozzetto
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引用次数: 0

Abstract

Purpose: Arteriovenous fistula (AVF), the preferred vascular access for hemodialysis, is associated with high failure rate. The aim of this study was to investigate the potential of AVF sound auscultation in providing quantitative information on AVF hemodynamic conditions.

Methods: This single-center prospective study involved six patients with native radio-cephalic AVFs who underwent multiple follow-up visits. Doppler Ultrasound blood flow volume (BFV) assessment and electronic stethoscope-based sound recordings were performed during each visit, whereas MRIs were acquired 3 days, 3 weeks and 1 year after surgery. Computational fluid dynamic (CFD) simulations were performed on patient-specific MRI-derived geometrical models.

Results: Higher values of median peak amplitudes ratios (high-low peak ratio-HLPR) were found to be associated with complex blood flow and velocity streamlines recirculation at systolic peak, and corresponding extended regions of high oscillatory shear index (OSI). On the contrary, lower values of HLPR were associated with laminar flow pattern and low values of OSI. Significant differences were observed in HLPR between subgroups with extended or limited areas with OSI > 0.1 (0.67 vs 0.31, respectively). Significant relationships were found between AVF sound intensity and brachial BFV (slope = 0.103, p < 0.01) as well as between longitudinal changes in brachial BFV and HLPR (slope = - 0.001, p < 0.01).

Conclusion: Our results show that AVF sound can be exploited to extract fundamental information on AVF hemodynamic conditions, providing indication of the presence of complex hemodynamic and adequate BFV to perform hemodialysis. Sound analysis has therefore the potential to improve clinical AVF surveillance and to ameliorate outcome.

声音分析揭示血液透析动静脉瘘管血液动力学状况的潜力。
目的:动静脉内瘘(AVF)是血液透析的首选血管通路,但其失败率很高。本研究旨在探讨 AVF 听诊在提供 AVF 血流动力学状况定量信息方面的潜力:这项单中心前瞻性研究涉及 6 名接受多次随访的原发性放射状脑动静脉瘘患者。每次就诊时都进行了多普勒超声血流容积(BFV)评估和电子听诊器声音记录,术后 3 天、3 周和 1 年分别进行了核磁共振成像检查。计算流体动力学(CFD)模拟在患者特定的磁共振成像衍生几何模型上进行:结果:研究发现,中位峰值振幅比(高低峰值比-HLPR)值较高与收缩期峰值的复杂血流和速度流线再循环以及相应的高振荡剪切指数(OSI)扩展区域有关。相反,较低的 HLPR 值与层流模式和较低的 OSI 值有关。在 OSI > 0.1 的扩展区域和受限区域的亚组之间,HLPR 存在显著差异(分别为 0.67 和 0.31)。发现动静脉瓣膜声强与肱动脉BFV之间存在显著关系(斜率=0.103,P 结论:动静脉瓣膜声强与肱动脉BFV之间存在显著关系:我们的研究结果表明,动静脉瓣膜声音可用于提取动静脉瓣膜血流动力学状况的基本信息,为进行血液透析提供存在复杂血流动力学和足够 BFV 的指示。因此,声音分析具有改善临床动静脉瘘监测和改善预后的潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Biomedical Engineering
Annals of Biomedical Engineering 工程技术-工程:生物医学
CiteScore
7.50
自引率
15.80%
发文量
212
审稿时长
3 months
期刊介绍: Annals of Biomedical Engineering is an official journal of the Biomedical Engineering Society, publishing original articles in the major fields of bioengineering and biomedical engineering. The Annals is an interdisciplinary and international journal with the aim to highlight integrated approaches to the solutions of biological and biomedical problems.
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