Coronary flow velocity reserve and carotid intima media thickness in patients with autosomal dominant polycystic kidney disease: from impaired tubules to impaired carotid and coronary arteries.
OBJECTIVE
Cardiovascular problems are a major cause of morbidity and mortality in patients with autosomal dominant polycystic kidney disease. Endothelial dysfunction, an early and reversible feature in the pathogenesis of atherosclerosis, is associated with increased vascular smooth muscle tone, arterial stiffening, and increased intima-media thickness. Coronary flow velocity reserve is a noninvasive test showing endothelial function of epicardial coronary arteries and coronary microcirculatory function. The aim of the study was to investigate the carotid intima-media thickness and coronary flow velocity reserve in patients with autosomal dominant polycystic kidney disease.


METHODS
Thirty normotensive patients with autosomal dominant polycystic kidney disease (10 male, 20 female) with well-preserved renal function and 30 healthy subjects (12 male, 18 female) were included in the study. Coronary flow velocity reserve was measured at baseline and after dipyridamole infusion by echocardiography. Coronary flow velocity reserve was calculated as the ratio of hyperemic to baseline diastolic peak velocities.


RESULTS
Carotid intima-media thickness was significantly higher in patients than in control subjects (0.80 +/- 0.29 versus 0.54 +/- 0.14 mm, respectively; P < 0.001). Moreover, coronary flow velocity reserve was significantly lower in patients than in control subjects (1.84 +/- 0.39 versus 2.65 +/- 0.68, respectively; P < 0.001).


CONCLUSIONS
Normotensive patients with autosomal dominant polycystic kidney disease with well-preserved renal function have significantly increased carotid intima-media thickness and significantly decreased coronary flow velocity reserve compared with healthy subjects. These findings suggest that atherosclerosis starts at an early stage in the course of their disease in patients with autosomal dominant polycystic kidney disease.
Turkmen
Kultigin
K
Department of Internal Medicine, Istanbul School of Medicine, Istanbul, Turkey.
Oflaz
Huseyin
H
Uslu
Bora
B
Cimen
Arif O
AO
Elitok
Ali
A
Kasikcioglu
Erdem
E
Alisir
Sabahat
S
Tufan
Fatih
F
Namli
Sule
S
Uysal
Mukremin
M
Ecder
Tevfik
T
D000328:Adult; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D001783:Blood Flow Velocity; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016022:Case-Control Studies; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000503:physiopathology*; D025401:Echocardiography, Stress; D005260:Female; D006801:Humans; D007684:Kidney Tubules / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology