Tissue Doppler Imaging in the Evaluation of Left Ventricular Function in Young Adults With Autosomal Dominant Polycystic Kidney Disease

Background: Hypertension and increased left ventricular mass index (LVMI) have been reported in patients with early stages of autosomal dominant polycystic kidney disease (ADPKD). Whether these abnormalities are associated with diastolic dysfunction in this stage remains to be established. The aim of the study is to evaluate diastolic function in young normotensive patients with ADPKD by using tissue Doppler imaging (TDI), the most sensitive method available to date. Methods: Thirty-two young clinically normotensive patients aged 21 to 30 years were compared with 23 controls with similar ages. Ambulatory blood pressure measurement (ABPM) was performed to confirm normal blood pressure. Subsequently, patients and controls underwent echocardiography using transmitral Doppler and TDI. Results: LVMI was greater in patients with ADPKD than controls (89.3 ± 17.7 versus 77.6 ± 15.9 g/m2; P < 0.02). No significant differences were found in transmitral Doppler and TDI results. When ABPMs were taken into account, 11 patients had mild hypertension and showed increased LVMI and decreased early diastolic peak velocity (E wave: 67.0 ± 12.0 cm/s in hypertensive patients with ADPKD versus 81.4 ± 3.3 cm/s in normotensive patients with ADPKD versus 79.3 ± 2.9 cm/s in controls; P < 0.04) and decreased TDI peak early diastolic annular velocity (11.6 ± 2.8 cm/s in hypertensive patients with ADPKD versus 13.2 ± 1.6 cm/s in normotensive patients with ADPKD versus 13.4 ± 1.6 in controls; P < 0.05). Conclusion: Diastolic dysfunction is not a prominent sign in young normotensive patients with ADPKD.