<b>Cardiac Adaptation in a Murine Iliac Arteriovenous Fistula Model and the Impact of Sex and N-Acetylcysteine Supplementation</b>

Ultrasound, echocardiography, and cardiac myocyte mitochondrial respiratory testing were performed. AVF creation produced significant aortic flow increases and corresponding diameter growth(male +64%, female +109%, p=0.001). Heart weight increased ~30-40mg over sham for both sexes(p=0.001).

Female AVF mice demonstrated higher ejection fraction(94.8±5.1% vs. male-83.1±7.5%, p=0.001) and attenuated diastolic volume increase(32.8±11.8μl vs. 46.5±15.1μl, p=0.003). AVF inflow did not correlate with LV mass or ejection fraction. Cardiac mitochondrial oxidative phosphorylation(OXPHOS) was higher in female AVF mice(sex-effect p=0.01) and trended toward correlation with ejection fraction(p=0.06).

NAC did not alter cardiac structure or function but was associated with a trend toward improved OXPHOS in females(p=0.09). Murine iliac AVF creation results in compensated cardiac hypertrophy without heart failure replicating observations documented in patients. Female sex is associated with greater cardiac myocyte mitochondrial function and adaptive remodeling, implicating sex-specific redox biology in AVF-related cardiac outcomes.</p>