Pfeferman Mariana Becker, Rocha Daniel Ribeiro da, Rodrigues Fernanda Guedes, Pfeferman Elcio, Heilberg Ita Pfeferman
Universidade Santo Amaro (UNISA) Medical School, São Paulo 04829-300, Brazil.
Nephrology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-062, Brazil.
J Clin Med. 2022 Oct 11;11(20):5982. doi: 10.3390/jcm11205982.
Cardiovascular abnormalities, such as left ventricular hypertrophy and valvular disorders, particularly mitral valve prolapse, have been described as highly prevalent among adult patients with autosomal dominant polycystic kidney disease (ADPKD). The present study aimed to assess echocardiographic parameters in a large sample of both normotensive and hypertensive ADPKD patients, regardless of kidney function level, and evaluate their association with clinical and laboratorial parameters. A retrospective study consisted of the analysis of clinical, laboratorial, and transthoracic echocardiograms data retrieved from the medical records of young adult ADPKD outpatients. A total of 294 patients (120 M/174 F, 41.0 ± 13.8 years old, 199 hypertensive and 95 normotensive) with a median estimated glomerular filtration rate (eGFR) of 75.5 mL/min/1.73 m were included. The hypertensive group (67.6%) was significantly older and exhibited significantly lower eGFR than the normotensive one. Increased left ventricular mass index (LVMI) was seen in 2.0%, mitral valve prolapse was observed in 3.4%, mitral valve regurgitation in 15.3%, tricuspid valve regurgitation in 16.0%, and aortic valve regurgitation in 4.8% of the whole sample. The present study suggested that the prevalence of mitral valve prolapse was much lower than previously reported, and increased LVMI was not seen in most adult ADPKD patients.
心血管异常,如左心室肥厚和瓣膜疾病,尤其是二尖瓣脱垂,在常染色体显性多囊肾病(ADPKD)成年患者中极为常见。本研究旨在评估大量血压正常和高血压的ADPKD患者的超声心动图参数,无论其肾功能水平如何,并评估这些参数与临床和实验室参数之间的关联。一项回顾性研究,分析了从年轻成年ADPKD门诊患者病历中获取的临床、实验室和经胸超声心动图数据。共纳入294例患者(男性120例/女性174例,年龄41.0±13.8岁,高血压患者199例,血压正常患者95例),估计肾小球滤过率(eGFR)中位数为75.5 mL/min/1.73 m²。高血压组(67.6%)年龄显著更大,且eGFR显著低于血压正常组。整个样本中,2.0%的患者左心室质量指数(LVMI)升高,3.4%的患者观察到二尖瓣脱垂,15.3%的患者有二尖瓣反流,16.0%的患者有三尖瓣反流,4.8%的患者有主动脉瓣反流。本研究表明,二尖瓣脱垂的患病率远低于先前报道,且大多数成年ADPKD患者未出现LVMI升高。