Left ventricular hypertrophy in hypertensive patients with autosomal dominant polycystic kidney disease: Influence of blood pressure and humoral and neurohormonal factors
A. Martinez-vea et al., Left ventricular hypertrophy in hypertensive patients with autosomal dominant polycystic kidney disease: Influence of blood pressure and humoral and neurohormonal factors, AM J NEPHR, 20(3), 2000, pp. 193-200
Left ventricular hypertrophy (LVH) is a common finding in hypertensive auto
somal dominant polycystic kidney disease (ADPKD) patients. There are few st
udies on the influence of blood pressure (BP) and nonhemodynamic factors on
LVH in these patients. The aim of this study was to evaluate the relations
hip between BP, humoral and neurohormonal factors and left ventricular mass
(LVM) in hypertensive ADPKD patients, in 20 hypertensive ADPKD patients, a
mbulatory BP was monitored far 24 h, left ventriclar dimensions were estima
ted by echocardiography, and plasma renin activity (PRA), plasma noradrenal
ine (NA), angiotensin II (Ang II), aldosterone, atrial natriuretic peptide
(ANP) and insulin-like growth factor I (IGF-I) were also determined. Twenty
age- and sex-matched essential hypertensive subjects served as controls. A
mbulatory BP and LVM index were similar in the two groups, although male AD
PKD patients had higher LVM indices than their matched controls. Eight ADPK
D patients (40%) and 6 essential hypertensives (30%) showed LVH. PRA, Ang I
I, aldosterone, ANP and IGF-I levels were similar in the two groups, but pl
asma NA levels were higher in ADPKD patients than in controls (281 +/- 158
vs. 160 +/- 62 pg/ml, p = 0.004). ADPKD patients with LVH did not differ fr
om those without LVH with regard to humoral and neurohormonal parameters, b
ut had higher ambulatory BP levels. In ADPKD patients, correlation analysis
revealed a significant association between LVM index and 24-hour systolic
and diastolic BP, but not with any of the hormonal factors evaluated. On mu
ltiple regression analysis, 24-hour diastolic BP was the only independent v
ariable linked to LVM index. In conclusion, ambulatory BP is one of the mos
t important determinants of LVM in hypertensive ADPKD patients. Further stu
dies are warranted to elucidate the role of nonhemodynamic factors in the p
athogenesis of LVH in this population. Copyright (C) 2000 S. Karger AG, Bas
el.