Left ventricular mass and diastolic function in normotensive young adults with autosomal dominant polycystic kidney disease

Left ventricular hypertrophy is often found very early in the course of aut osomal dominant polycystic kidney disease (ADPKD). Diastolic dysfunction ha s been shown in hypertensive adult patients with ADPKD with increased left ventricular mass (LVM), but there are no data about diastolic function in t he young ADPKD population without hypertension and with normal renal functi on. To evaluate very early alterations in cardiac structure and diastolic f unction in young normotensive patients with ADPKD, color Doppler echocardio graphy was performed in 46 young normotensive patients with ADPKD and 35 he althy subjects. LVM, transmitral pulsed Doppler flow (diastolic function), and valvular abnormalities were studied. Patients with ADPKD showed higher LVM indices (LVMls) than controls (89.7 +/- 17.3 v 68.5 +/- 17.2 g/m(2); P < 0.0001). Peak early diastolic velocity (E wave) deceleration time and iso volumic 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 +/- 1 5 msec; P = 0.0001). No differences were found in valvular abnormalities in the two groups. In conclusion, young normotensive patients with ADPKD show ed increased LVMls and Doppler abnormalities consistent with early diastoli c dysfunction. (C) 1998 by the National Kidney Foundation, Inc.