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Pulmonary artery hypertension is common in patients undergoing hemodialysis. Its main causes are hypervolemia and high cardiac output that may occur in end-stage renal disease. This study has been made in order to assess the influence of haemodialysis on pulmonary haemodinamics, as well as the correlation between these effects, myocardial function before dialysis and some associated conditions. The 40 studied patients had chronic renal insufficiency and they were on maintenance haemodialysis. High blood pressure was noted in all cases (100%). In varied percentage, other conditions associated to end-stage renal disease were coronary artery disease, mitral and/or aortic valvulopathies, exudative pericarditis, chronic pulmonary diseases and clinically manifest heart failure. 10% of patients were smokers. Subjects were assessed by transthoracic echocardiography before and after haemodialysis session, in order to estimate pulmonary artery systolic pressure, as well as systolic and diastolic ventricles function. Authors found an important reduction in frequency of pulmonary hypertension (32,5% postdialytic vs 80% predialytic; p < 0,01) and in its severity, after dialysis. Moreover, haemodialysis led to a normalized pulmonary artery pressure in 40% of cases, statistically significant (p < 0,001). The improvement of pulmonary hypertension was noted especially in patients that, before dialysis, had left ventricle both systolic and diastolic impairment (29,5% postdialytic vs 82,4% predialytic; p < 0,005) and in those with normal right ventricle diastolic function (18,2% postdialytic vs 72,7% predialytic; p < 0,05). Smoking, as well as respiratory and heart diseases, were associated with a high rate of predialytic pulmonary hypertension, up to 100%. Prevalence droped after dialysis, no mather of coexistent diseases; variation had statistic significance in patients with coronary artery disease (34,7% postdialytic vs 82,5% predialytic; p < 0,005), mitral and/or aortic valvulopathies (32,4% postdialytic vs 83,8% predialytic; p < 0,001) and clinically manifest heart failure (40,6% postdialytic vs 87,5% predialytic; p < 0,001). Conclusions: pulmonary hypertension is common in dialysed patients and its main pathogenetic mechanism is hypervolemia; haemodialysis is an efficient way to treat pulmonary hypertension in patients with chronic terminal renal insufficiency, no mather of predialytic myocardial function or associated cardio-respiratory diseases. [ABSTRACT FROM AUTHOR]

Ischaemic heart disease and heart rhythm disturbances are common in patients with chronic renal insufficiency. Renal replacement therapy is the specific field where both myocardial ischaemia and arrhythmias may occur, enhance and influence each other. Regarding that, authors studied 42 patients who had chronic renal insufficiency, on maintenance haemodialysis. Patients have been assessed by extradialytic rest electrocardiography, intradialytic Holter EKG examination and transthoracic echocardiography before dialysis. The goals of the research were recording background ischaemia versus intradialytic ischaemic variability, intradialytic heart rhythm disturbances, as well as impaired left and right ventricle function associated with arrhythmias. Authors found a low prevalence (16,7%) of intradialytic ischaemic variability vs background ischaemia (45,2%), suggesting that haemodialysis does not lead to myocardial ischaemia and does not increas previous ischaemia. On the other hand, variable ischaemia was associated to heart rhythm disturbances in all patients, especially premature heart beats (100%). Dialysis-related heart rhythm disturbances had a high-rate frequency (97,6%), in correlation with the presence of impaired myocardial function and not with the sort of it. [ABSTRACT FROM AUTHOR]

Liver involvement in Coronavirus Disease 2019 (COVID-19) has been widely documented. However, data regarding liver-related prognosis are scarce and heterogeneous. The current study aims to evaluate the role of abnormal liver tests and incidental elevations of non-invasive fibrosis estimators on the prognosis of hospitalized COVID-19 patients. We conducted a retrospective cohort study to investigate the impact of elevated liver tests, non-invasive fibrosis estimators (the Fibrosis-4 (FIB-4), Forns, APRI scores, and aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio), and the presence of computed tomography (CT)-documented liver steatosis on mortality in patients with moderate and severe COVID-19, with no prior liver disease history. A total of 370 consecutive patients were included, of which 289 patients (72.9%) had abnormal liver biochemistry on admission. Non-survivors had significantly higher FIB-4, Forns, APRI scores, and a higher AST/ALT ratio. On multivariate analysis, severe FIB-4 (exceeding 3.25) and elevated AST were independently associated with mortality. Severe FIB-4 had an area under the receiver operating characteristic (AUROC) of 0.73 for predicting survival. The presence of steatosis was not associated with a worse outcome. Patients with abnormal liver biochemistry on arrival might be susceptible to a worse disease outcome. An FIB-4 score above the threshold of 3.25, suggestive of the presence of fibrosis, is associated with higher mortality in hospitalized COVID-19 patients. [ABSTRACT FROM AUTHOR]

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The authors present a classification of the most important types of online resources regarding the ankle-brachial index, for patients with peripheral arterial disease and other interested people (websites of national institutes, universities of medicine, regional hospitals, medical societies and associations etc). [ABSTRACT FROM AUTHOR]