Bardají A, Vea A M, Gutierrez C, Ridao C, Richart C, Oliver J A
Cardiology Section, Hospital Universitario de Tarragona Joan XXIII, Spain.
Am J Kidney Dis. 1998 Dec;32(6):970-5. doi: 10.1016/s0272-6386(98)70071-x.
Left ventricular hypertrophy is often found very early in the course of autosomal dominant polycystic kidney disease (ADPKD). Diastolic dysfunction has been shown in hypertensive adult patients with ADPKD with increased left ventricular mass (LVM), but there are no data about diastolic function in the young ADPKD population without hypertension and with normal renal function. To evaluate very early alterations in cardiac structure and diastolic function in young normotensive patients with ADPKD, color Doppler echocardiography was performed in 46 young normotensive patients with ADPKD and 35 healthy subjects. LVM, transmitral pulsed Doppler flow (diastolic function), and valvular abnormalities were studied. Patients with ADPKD showed higher LVM indices (LVMIs) than controls (89.7+/-17.3 v 68.5+/-17.2 g/m2; P < 0.0001). Peak early diastolic velocity (E wave) deceleration time and isovolumic relaxation time were significantly prolonged in patients with ADPKD compared with controls (E wave deceleration time, 182.5+/-51.3 v 149.4+/-34 msec; P=0.002; isovolumic relaxation time, 97.7+/-17.5 v 79+/-15 msec; P=0.0001). No differences were found in valvular abnormalities in the two groups. In conclusion, young normotensive patients with ADPKD showed increased LVMIs and Doppler abnormalities consistent with early diastolic dysfunction.
左心室肥厚在常染色体显性多囊肾病（ADPKD）病程中往往很早就会出现。舒张功能障碍在左心室质量（LVM）增加的成年ADPKD高血压患者中已有报道，但在无高血压且肾功能正常的年轻ADPKD人群中，尚无关于舒张功能的数据。为了评估年轻血压正常的ADPKD患者心脏结构和舒张功能的早期改变，对46例年轻血压正常的ADPKD患者和35名健康受试者进行了彩色多普勒超声心动图检查。研究了LVM、经二尖瓣脉冲多普勒血流（舒张功能）和瓣膜异常情况。ADPKD患者的LVM指数（LVMIs）高于对照组（89.7±17.3对68.5±17.2g/m2；P<0.0001）。与对照组相比，ADPKD患者舒张早期峰值速度（E波）减速时间和等容舒张时间显著延长（E波减速时间，182.5±51.3对149.4±34毫秒；P=0.002；等容舒张时间，97.7±17.5对79±15毫秒；P=0.0001）。两组在瓣膜异常方面未发现差异。总之，年轻血压正常的ADPKD患者表现出LVMIs增加和与早期舒张功能障碍一致的多普勒异常。
