title: Impairment of heart rate recovery index in autosomal-dominant polycystic kidney disease patients without hypertension.
abstract: BACKGROUND
  We aimed to determine the status of the autonomic nervous system in patients with autosomal-dominant polycystic kidney disease (ADPKD) who were normotensive and had normal renal function.
  
  
  METHODS
  A total of 28 normotensive ADPKD patients with normal renal function and 30 healthy control subjects consented to participate in the study. Heart rate recovery (HRR) indices were defined as the reduction in heart rate from the rate at peak exercise to the rate at the 1st, 2nd, 3rd and 5th minutes after the cessation of the exercise stress test; these results were indicated HRR(1), HRR(2), HRR(3) and HRR(5), respectively.
  
  
  RESULTS
  The 1st- and 2nd-minute HRR indices of patients with ADPKD were significantly lower than those of the healthy control group (27.1±7.9 vs 32.0±7.9; p=0.023 and 46.9±11.5 vs 53.0±9.0; p=0.029, respectively). Similarly, HRR indices after the 3rd and 5th minutes of the recovery period were significantly lower in patients with ADPKD when compared with indices in the control group (56.7±12.0 vs 65.1±11.2; p=0.008 and 62.5±13.8 vs 76.6±15.5; p =0.001, respectively).
  
  
  CONCLUSIONS
  Impaired HRR index is associated with normotensive early-stage ADPKD patients. Increased renal ischemia and activation of the renin-angiotensin-aldosterone system (RAAS) may contribute to impairment in the autonomic nervous system in these patients before the development of hypertension. Even if ADPKD patients are normotensive, there appears to be an association with autonomic dysfunction and polycystic kidney disease.
authors.affiliation: Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey.
authors.forename: Ozcan
authors.initials: O
authors.lastname: Orscelik
authors.forename: Ismail
authors.initials: I
authors.lastname: Kocyigit
authors.forename: Oguzhan
authors.initials: O
authors.lastname: Baran
authors.forename: Coskun
authors.initials: C
authors.lastname: Kaya
authors.forename: Orhan
authors.initials: O
authors.lastname: Dogdu
authors.forename: Halit
authors.initials: H
authors.lastname: Zengin
authors.forename: Serhat
authors.initials: S
authors.lastname: Karadavut
authors.forename: Omer
authors.initials: O
authors.lastname: Gedikli
authors.forename: Engin
authors.initials: E
authors.lastname: Kut
authors.forename: Mustafa
authors.initials: M
authors.lastname: Duran
authors.forename: Bekir
authors.initials: B
authors.lastname: Calapkorur
authors.forename: Bulent
authors.initials: B
authors.lastname: Tokgoz
authors.forename: Mehmet Gungor
authors.initials: MG
authors.lastname: Kaya
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000503:physiopathology*