Orscelik Ozcan, Kocyigit Ismail, Baran Oguzhan, Kaya Coskun, Dogdu Orhan, Zengin Halit, Karadavut Serhat, Gedikli Omer, Kut Engin, Duran Mustafa, Calapkorur Bekir, Tokgoz Bulent, Kaya Mehmet Gungor
Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey.
Blood Press. 2012 Oct;21(5):300-5. doi: 10.3109/08037051.2012.680691. Epub 2012 May 1.
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.
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.
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).
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.
我们旨在确定血压正常且肾功能正常的常染色体显性遗传性多囊肾病（ADPKD）患者的自主神经系统状况。
共有28例血压正常且肾功能正常的ADPKD患者和30名健康对照者同意参与本研究。心率恢复（HRR）指标定义为运动应激试验停止后，心率从运动峰值时的心率降至第1、2、3和5分钟时的心率降低值；这些结果分别表示为HRR(1)、HRR(2)、HRR(3)和HRR(5)。
ADPKD患者第1分钟和第2分钟的HRR指标显著低于健康对照组（分别为27.1±7.9对32.0±7.9；p=0.023以及46.9±11.5对53.0±9.0；p=0.029）。同样，与对照组相比，ADPKD患者恢复期第3分钟和第5分钟后的HRR指标也显著更低（分别为56.7±12.0对65.1±11.2；p=0.008以及62.5±13.8对76.6±15.5；p =0.001）。
HRR指标受损与血压正常的早期ADPKD患者相关。肾缺血增加和肾素-血管紧张素-醛固酮系统（RAAS）激活可能在这些患者发生高血压之前就导致自主神经系统受损。即使ADPKD患者血压正常，自主神经功能障碍与多囊肾病之间似乎也存在关联。
