Biventricular diastolic dysfunction in patients with autosomal-dominant polycystic kidney disease.
BACKGROUND
Left ventricular diastolic dysfunction has been shown in patients with autosomal-dominant polycystic kidney disease (ADPKD). However, there is no study evaluating right ventricular functions in these patients.


METHODS
In the present study, diastolic functions of both ventricles in normotensive and hypertensive ADPKD patients with well-preserved renal function were investigated. Fifteen hypertensive and 16 normotensive patients with ADPKD with well-preserved renal function, 16 patients with essential hypertension, and 24 healthy subjects were included in the study. Conventional left and right ventricular echocardiographic measurements were performed in all subjects. Left and right ventricular functions were investigated both by myocardial performance index (MPI) [calculated by dividing the sum of isovolumic contraction time and isovolumic relaxation time (IVRT) by ejection time] and by tissue Doppler imaging (TDI).


RESULTS
Left ventricular deceleration time and IVRT were significantly prolonged in hypertensive patients with ADPKD compared with patients with essential hypertension and even in normotensive patients with ADPKD compared with healthy subjects. Left and right MPIs were significantly higher in patients with ADPKD compared with healthy subjects, showing systolic and diastolic dysfunction. Moreover, by using TDI, the peak early diastolic mitral annular velocity (Em) to peak late diastolic mitral annular velocity (Am) ratio and the peak early diastolic tricuspid annular velocity (Et) to peak late diastolic tricuspid annular velocity (At) ratio were decreased in patients with ADPKD, suggesting biventricular diastolic dysfunction.


CONCLUSIONS
Both hypertensive and normotensive patients with ADPKD show significant biventricular diastolic dysfunction, suggesting cardiac involvement very early in the course of ADPKD.
Oflaz
Huseyin
H
Department of Cardiology, Istanbul School of Medicine, Istanbul University, Turkey.
Alisir
Sabahat
S
Buyukaydin
Banu
B
Kocaman
Orhan
O
Turgut
Faruk
F
Namli
Sule
S
Pamukcu
Burak
B
Oncul
Aytac
A
Ecder
Tevfik
T
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003404:Creatinine / Q000378:metabolism; D003971:Diastole; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications*; D013599:Systole; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000209:etiology*
D000959:Antihypertensive Agents; D003404:Creatinine