Epicardial Fat Thickness in Patients with Autosomal Dominant Polycystic Kidney Disease

Abstract

Introduction: Autosomal dominant polycystic kidney disease (ADPKD) is associated with early organ damage such as left ventricular hypertrophy and higher cardiovascular risk when compared to essential hypertension (EH). Epicardial adipose tissue (EAT) is a new cardiovascular risk factor, but its role and correlation with left ventricular mass (LVM) in ADPKD is unknown. Aims: we sought to investigate whether EAT is higher and related to LVM indexed by body surface area (LVMi) in hypertensive patients with ADPKD compared to those with EH. Methods: We performed ultrasound measurement of EAT thickness, LVM, LVMi, and left atrium size (left atrial volume indexed for body surface, LAVI) in 41 consecutive hypertensive patients with ADPKD, compared to 89 EH patients. Results: EAT was significantly higher in the ADPKD group in comparison to EH subjects (9.2 ± 2.9 mm vs. 7.8 ± 1.6 mm, p < 0.001), and significantly correlated with LVM, LVMi, and LAVI in the ADPKD group (r = 0.56, p = 0.005; r = 0.424, p = 0.022; and r = 0.48, p = < 0.001, respectively). Comparing EAT against body mass index, systolic blood pressure, and age, we found that EAT was the strongest predictor of LVMi (β = 0.42, p = 0.007). Conclusion: Our data showed that EAT was higher in ADPKD patients than in EH subjects and independently correlated with LVMi. EAT measurement can be a useful marker for the cardiovascular risk stratification in ADPKD.

Effect of Low-Protein Diet and Inulin on Microbiota and Clinical Parameters in Patients with Chronic Kidney Disease

“…Local production and the release of cytokines such as TNF-α, IL-6, and IL-1β could cause further disruption of intercellular tight junctions, increasing intercellular permeability. Moreover, CRP could act directly on the vascular endothelium, increasing the expression of adhesion molecules, reducing the expression of nitric oxide (NO) in endothelial cells, and altering low-density lipoprotein (LDL) [27,28]. We showed a significant reduction of SUA levels, which is considered a cardiovascular risk factor and it may promote endothelial dysfunction by increasing oxidative stress and thus favoring the development of atherosclerosis [29,30].…”

Assessment of Cardiovascular Disease in Autosomal Dominant Polycystic Kidney Disease

“…In recent years, several studies have been focused on the correlation between epicardial adipose tissue and other possible cardiovascular risk factors. In three studies, ADPKD patients had more epicardial adipose tissue (EAT), associated with a higher risk of cardiovascular events [37,38]. EAT is considered a proper tissue with neuroendocrine functions, and its thickness is related with all the classical cardiovascular risk factors such as IMT and LVH.…”

A Systematic Review of Reported Outcomes in ADPKD Studies

“…Nineteen studies assessed left ventricular mass indexed to body surface area, 16,23,27,28,30,32,[35][36][37]40,45,50,54,55,62,74,142,167,168 whereas 2 studies evaluated left ventricular mass, 167,168 only 1 study evaluated percent predicted left ventricular mass based on height, weight, and gender…”

“…167 Both left ventricular mass and left ventricular mass index were measured by either echocardiography, 16,23,27,28,30,32,35,45,50,54,55,62,74,168 or by MRI. 36,37,40,167 Other evaluated cardiac parameters include epicardial adipose tissue thickness, 168,169 left ventricular twist and untwisting rate 23 left atrial volume, left ventricular ejection fraction, 23 mitral valve prolapse, 27,54,74,110 and other valvular abnormalities. 27 The full list of the evaluated cardiac outcomes is illustrated in Supplementary Table S3.…”