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Use of Ultra-high Field MRI in Small Rodent Models of Polycystic Kidney Disease for In Vivo Phenotyping and Drug Monitoring
Published on: June 23, 2015
Echocardiographic characteristics of autosomal dominant polycystic kidney disease
Agata Koska-Ścigała1, Hanna Jankowska2, Magdalena Jankowska3
1Department of Neurology, Regional Hospital in Elbląg, Elbląg, Poland.
Insights
Cardiovascular abnormalities are common in autosomal dominant polycystic kidney disease (ADPKD). Left ventricular hypertrophy and diastolic dysfunction are prevalent, linked to kidney function decline.
Area of Science:
- Nephrology
- Cardiology
- Genetics
Background:
- Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder.
- Cardiovascular complications are frequent but outcomes are contradictory.
- Extrarenal manifestations require thorough investigation.
Purpose of the Study:
- To determine the prevalence of cardiovascular abnormalities in ADPKD patients using echocardiography.
- To associate cardiac findings with clinical characteristics and CKD progression.
- To understand the cardiac phenotype in ADPKD.
Main Methods:
- Transthoracic echocardiography performed on 68 ADPKD patients.
- Collected demographic, medical history, and medication data.
- Assessed chronic kidney disease (CKD) progression via creatinine levels over one year.
Main Results:
- Over 40% of patients exhibited left ventricular hypertrophy (LVH).
- Declining eGFR correlated with increased left ventricular mass.
- Asymptomatic left ventricular diastolic dysfunction (ALVDD), left atrium enlargement, and valvular regurgitations were common.
Conclusions:
- LVH, LA enlargement, ALVDD, and valvular regurgitations characterize the cardiac phenotype in ADPKD.
- Cardiac indices did not vary significantly across CKD stages.
- ADPKD diagnosis appears to be the primary driver of cardiac abnormalities.
Abstract:
Cardiovascular complications in patients with autosomal dominant polycystic kidney disease (ADPKD) are frequently investigated extrarenal manifestations with contradictory outcomes. The primary goal of this study is to explore the prevalence of cardiovascular abnormalities using echocardiography and analyze their associations with clinical characteristics at different stages of chronic kidney disease (CKD) progression in ADPKD patients. We included sixty-eight patients in the study. All patients underwent transthoracic echocardiography using GE Vingmed Ultrasound (GE Norway Health Tech, Oslo, Norway). Demographic information, prior medical history, and antihypertensive medication use were recorded. To diagnose the rapid progression of CKD, creatinine levels were measured twice, with a one-year interval. Analysis revealed left ventricular hypertrophy (LVH) in over 40% of ADPKD patients, as indicated by various LVH parameters. Notably, a decline in estimated glomerular filtration rate (eGFR) after one year of observation was associated with increased left ventricular mass. Other prevalent findings included asymptomatic left ventricular diastolic dysfunction (ALVDD) in 39% of patients, left atrium (LA) enlargement in 39%, and mild valvular regurgitations in 80%. Ejection fraction, aortic root dimension, and the prevalence of mitral valve prolapse were not significantly increased. Cardiac indices did not differ substantially across the different eGFR stages. LVH, LA enlargement, ALVDD and valvular regurgitations are characteristics of cardiac phenotype in ADPKD. Cardiac indices were not different across different stages of CKD pointing towards the diagnosis of ADPKD being the main drive of their occurrence.
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