Section of General Medicine and Hypertension, Department of Medicine, Policlinico GB Rossi, University of Verona, 37134 Verona, Italy.
Pediatric Clinic, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37126 Verona, Italy.
Medicina (Kaunas). 2023 Oct 5;59(10):1777. doi: 10.3390/medicina59101777.
: Hypertension and vascular damage can begin in adolescents affected by Autosomal Dominant Polycystic Kidney Disease (ADPKD). This study aimed to evaluate markers of vascular damage and left ventricular geometry in a sample of children with ADPKD. : Several vascular measurements were obtained: ambulatory blood pressure monitoring (ABPM), carotid intima-media thickness (cIMT), carotid distensibility coefficient (cDC), pulse wave velocity (PWV), and echocardiographic measurements (relative wall thickness (RWT) and left ventricular mass index (LVMI)). : Eleven ADPKD children were recruited (four females and seven males, mean age 9.5 ± 3.2 years). Four children were hypertensive at the ABPM, five were normotensive, and for two ABPM was not available. RWT was tendentially high (mean 0.47 ± 0.39). Eight patients had concentric cardiac remodeling, while one patient had cardiac hypertrophy. cIMT was above the 95° percentile for sex and height in 80% of the children (0.5 ± 0.005 mm). The average PWV and cDC were between the normal range (5.5 ± 4.6 m/s and 89.6 ± 16.1 × 10/KPa, respectively). We observed a positive correlation between the PWV and RWT (r = 0.616; = 0.044) and a negative correlation between cDC and RWT (r = -0.770; = 0.015). Cardiovascular damages (cIMT > 95° percentile) were found in normotensive patients. : Increased RWT and high cIMT, indicating subclinical organ damage, are already present in ADPKD children. RWT was significantly correlated to that of cDC and PWV, implying that vascular stiffening is associated with cardiac remodeling. None of the children had an alteration in renal function. Subclinical cardiovascular damage preceded the decline in glomerular filtration rate.
: 常染色体显性多囊肾病(ADPKD)会影响青少年的血压和血管损伤。本研究旨在评估一组 ADPKD 患儿的血管损伤和左心室几何结构标志物。
: 获得了多项血管测量值:动态血压监测(ABPM)、颈动脉内膜中层厚度(cIMT)、颈动脉扩张系数(cDC)、脉搏波速度(PWV)和超声心动图测量值(相对室壁厚度(RWT)和左心室质量指数(LVMI))。
: 共招募了 11 名 ADPKD 患儿(4 名女性,7 名男性,平均年龄 9.5 ± 3.2 岁)。4 名儿童在 ABPM 时为高血压,5 名儿童为正常血压,2 名儿童的 ABPM 不可用。RWT 呈偏高趋势(平均 0.47 ± 0.39)。8 名患者存在向心性心脏重构,1 名患者存在心脏肥大。80%的儿童的 cIMT 高于同性别和同身高的第 95 百分位(0.5 ± 0.005 mm)。平均 PWV 和 cDC 在正常范围内(分别为 5.5 ± 4.6 m/s 和 89.6 ± 16.1 × 10/KPa)。我们观察到 PWV 与 RWT 之间存在正相关(r = 0.616; = 0.044),cDC 与 RWT 之间存在负相关(r = -0.770; = 0.015)。在正常血压患者中发现了心血管损害(cIMT>95 百分位)。
: 在 ADPKD 儿童中,已经存在升高的 RWT 和高 cIMT,这表明存在亚临床器官损害。RWT 与 cDC 和 PWV 显著相关,这表明血管僵硬与心脏重构有关。没有儿童的肾功能发生改变。亚临床心血管损害先于肾小球滤过率下降。