title: Cardiac magnetic resonance assessment of left ventricular mass in autosomal dominant polycystic kidney disease.
abstract: OBJECTIVE
  Autosomal dominant polycystic kidney disease (ADPKD) is associated with a substantial cardiovascular disease burden including early onset hypertension, intracranial aneurysms, and left ventricular hypertrophy (LVH). A 41% prevalence of LVH has been reported in ADPKD, using echocardiographic assessment of LV mass (LVM). The HALT PKD study was designed to assess the effect of intensive angiotensin blockade on progression of total kidney volume and LVM. Measurements of LVM were performed using cardiac magnetic resonance (MR).
  
  
  METHODS
  Five hundred forty-three hypertensive patients with GFR >60 ml/min per 1.73 m(2) underwent MR assessment of LVM at baseline. LVM was adjusted for body surface area and expressed as LVM index (LVMI; g/m(2)).
  
  
  RESULTS
  Baseline BP was 125.1 ± 14.5/79.3 ± 11.6 mmHg. Average duration of hypertension was 5.79 years. Prior use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers was present in 59.5% of patients. The prevalence of LVH assessed using nonindexed LVM (g) was 3.9% (n = 21, eight men and 13 women) and 0.93% (n = 5, one man and four women) using LVMI (g/m(2)). In exploratory analyses, the prevalence of LVH using LVM indexed to H(2.7), and the allometric index ppLVmass(HW), ranged from 0.74% to 2.23% (n = 4 to 12). Multivariate regression showed significant direct associations of LVMI with systolic BP, serum creatinine, and albuminuria; significant inverse associations with LVMI were found with age and female gender.
  
  
  CONCLUSIONS
  The prevalence of LVH in hypertensive ADPKD patients <50 years of age with short duration of hypertension, and prior use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers is low. Early BP intervention in ADPKD may have decreased LVH and may potentially decrease cardiovascular mortality.
authors: Mayo Clinic College of Medicine, Rochester, Minnesota, USA. rperrone@tuftsmedicalcenter.org
authors: Ronald D
authors: RD
authors: Perrone
authors: Kaleab Z
authors: KZ
authors: Abebe
authors: Robert W
authors: RW
authors: Schrier
authors: Arlene B
authors: AB
authors: Chapman
authors: Vicente E
authors: VE
authors: Torres
authors: James
authors: J
authors: Bost
authors: Diana
authors: D
authors: Kaya
authors: Dana C
authors: DC
authors: Miskulin
authors: Theodore I
authors: TI
authors: Steinman
authors: William
authors: W
authors: Braun
authors: Franz T
authors: FT
authors: Winklhofer
authors: Marie C
authors: MC
authors: Hogan
authors: Frederic
authors: F
authors: Rahbari-Oskoui
authors: Cass
authors: C
authors: Kelleher
authors: Amirali
authors: A
authors: Masoumi
authors: James
authors: J
authors: Glockner
authors: Neil J
authors: NJ
authors: Halin
authors: Diego
authors: D
authors: Martin
authors: Erick
authors: E
authors: Remer
authors: Nayana
authors: N
authors: Patel
authors: Ivan
authors: I
authors: Pedrosa
authors: Louis H
authors: LH
authors: Wetzel
authors: Paul A
authors: PA
authors: Thompson
authors: J Philip
authors: JP
authors: Miller
authors: K Ty
authors: KT
authors: Bae
authors: Catherine M
authors: CM
authors: Meyers
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006352:Heart Ventricles / Q000187:drug effects / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors