Cardiac involvement in patients with Autosomal Dominant Polycystic Kidney Disease and normal renal function after six years of follow-up

The aim of the follow-up study was to compare the changes of M-mode echocardiographic parameters in autosomal dominant polycystic kidney disease (ADPKD) patients and controls without renal failure during six years of observation and to explore the associations of these parameters with metabolic syndrome components and kidney function. We performed a follow-up examination in 37 ADPKD patients and 40 controls. Anthropometric parameters were measured and fasting venous blood sample from each patient was tested for glucose, insulin, C-peptide, HbA1c, creatinine, and urea concentrations. All subjects underwent standard two-dimensional M-mode echocardiography. Left ventricular hypertrophy (LVH) was diagnosed based on left ventricular mass index (LVMI) adjusted for body surface area (LVMI-S, LVH-S) or for height (LVMI-H, LVH-H). The prevalence of LVH was significantly greater in ADPKD patients than in controls (35% vs. 10%, p=0.012) according to the ESH/ESC criteria from 2013, and (27.0% vs. 7.5%, p=0.032) according to criteria from 2017. In patients with ADPKD, no significant increase of the echocardiographic parameters was observed in the 6 years between the initial examination and the follow-up examination. Cardiac involvement in women with ADPKD occurs at an earlier stage of the disease than in men. In patients with ADPKD treated for hypertension in accordance with the 2013 ESH/ESC Guidelines the progression of LVH was not observed during the 6-year follow-up, despite the deterioration of renal function. Obesity, blood pressure and renal function do not affect LVMI changes.