Improvement of coronary flow velocity reserve with telmisartan in patients with autosomal-dominant polycystic kidney disease.
OBJECTIVE
Endothelial dysfunction (ED) has been reported in patients with autosomal-dominant polycystic kidney disease (ADPKD). Coronary flow velocity reserve (CFVR) is a noninvasive test showing endothelial function of epicardial coronary arteries and coronary microcirculatory function. The aim of this study was to investigate the effect of the angiotensin receptor blocker, telmisartan, on CFVR in patients with ADPKD.


METHODS
Thirteen patients with ADPKD and well-preserved renal function and 22 healthy controls were included in the study. CFVR was measured at baseline and after dipyridamole infusion by echocardiography. CFVR was calculated as the ratio of hyperemic to baseline average peak diastolic velocities. After the baseline evaluation of CFVR, patients started telmisartan at a dose of 80 mg/day and were followed for 12 months. CFVR was remeasured after 6 and 12 months of therapy.


RESULTS
Patients with ADPKD had significantly lower CFVR compared to healthy subjects. CFVR increased significantly after 6 months and 12 months of telmisartan therapy (P = 0.001) in patients with ADPKD.


CONCLUSIONS
One year of telmisartan therapy significantly improved CFVR in patients with ADPKD. This finding suggests that the stimulation of the renin-angiotensin-aldosterone system contributes to the ED in these patients.
Alisir
Sabahat
S
Goztepe Training and Research Hospital; and Department of Internal Medicine, Istanbul School of Medicine, Istanbul, Turkey.
Turkmen
Kultigin
K
Alpay
Nilufer
N
Elitok
Ali
A
Oflaz
Huseyin
H
Uslu
Bora
B
Cimen
Arif
A
Kasikcioglu
Erdem
E
Tufan
Fatih
F
Ecder
Tevfik
T
D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology* / Q000627:therapeutic use; D001562:Benzimidazoles / Q000494:pharmacology* / Q000627:therapeutic use; D001565:Benzoates / Q000494:pharmacology* / Q000627:therapeutic use; D001783:Blood Flow Velocity / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D003326:Coronary Circulation / Q000187:drug effects*; D042783:Endothelial Cells / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D016891:Polycystic Kidney, Autosomal Dominant / Q000188:drug therapy / Q000503:physiopathology*; D012084:Renin-Angiotensin System / Q000187:drug effects; D000077333:Telmisartan
D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001565:Benzoates; D000077333:Telmisartan