Background: The aim of this study was to compare echocardiographic parameters in patients with autosomal dominant polycystic kidney disease (ADPKD) and in controls with normal kidney function taking into account gender and the presence of hypertension. Methods: 47 patients with ADPKD (age 36.3 ± 11.0 years) and 49 healthy controls (36.8 ± 9.2 years) were enrolled. M-mode echocardiography was performed in all subjects. Left ventricular hypertrophy (LVH) was diagnosed when the left ventricular mass index (LVMI) was greater than or equal to 125 g/m2 in males and 110 g/m2 in females. Results: The prevalence of LVH was greater in ADPKD patients than in controls (13% vs 2%; p=0.05). Among females, ADPKD patients demonstrated greater LVMI (87.9 ± 18.5 vs 68.8 ± 15 g/m2, p=0.00009) than controls. There was a positive correlation between LVMI and blood pressure in ADPKD females (Rs=0.54, p=0.027 for systole blood pressure-SBP and Rs=0.50, p=0.0053 for diastole blood pressure-DBP) but not in males. Conclusion: Left ventricular mass is increased in ADPKD females with normal renal function. A positive correlation between SBP and DBP and LVMI was found in ADPKD females but not in ADPKD males.
The aim of the follow-up study was to compare the changes of M-mode echocardiographic
parameters in autosomal dominant polycystic kidney disease (ADPKD) patients and controls
without renal failure during six years of observation and to explore the associations of these
parameters with metabolic syndrome components and kidney function. We performed
a follow-up examination in 37 ADPKD patients and 40 controls. Anthropometric parameters
were measured and fasting venous blood sample from each patient was tested for glucose,
insulin, C-peptide, HbA1c, creatinine, and urea concentrations. All subjects underwent standard
two-dimensional M-mode echocardiography. Left ventricular hypertrophy (LVH) was
diagnosed based on left ventricular mass index (LVMI) adjusted for body surface area (LVMI-
-S, LVH-S) or for height (LVMI-H, LVH-H). The prevalence of LVH was significantly greater
in ADPKD patients than in controls (35% vs. 10%, p=0.012) according to the ESH/ESC criteria
from 2013, and (27.0% vs. 7.5%, p=0.032) according to criteria from 2017. In patients with
ADPKD, no significant increase of the echocardiographic parameters was observed in the
6 years between the initial examination and the follow-up examination. Cardiac involvement
in women with ADPKD occurs at an earlier stage of the disease than in men. In patients with
ADPKD treated for hypertension in accordance with the 2013 ESH/ESC Guidelines the progression
of LVH was not observed during the 6-year follow-up, despite the deterioration of
renal function. Obesity, blood pressure and renal function do not affect LVMI changes.
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