Document Detail


Exercise blood pressure, cardiac structure, and diastolic function in young normotensive patients with polycystic kidney disease: a prehypertensive state.
MedLine Citation:
PMID:  15264179     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Increased left ventricular mass (LVM) and left ventricular hypertrophy have been found in early stages of autosomal dominant polycystic kidney disease (ADPKD). The mechanisms that lead to an increase in LVM in this population are unknown. The aim of this study is to evaluate blood pressure (BP) response to exercise and very early alterations in cardiac structure and diastolic function in young normotensive patients with ADPKD. METHODS: Color Doppler echocardiography and exercise treadmill testing according to the Bruce protocol were performed in 18 young normotensive patients with ADPKD and 18 healthy subjects. RESULTS: LVM index was greater and isovolumic relaxation time (IVRT) was longer in patients with ADPKD than controls (93.3 +/- 21.4 versus 77.5 +/- 18.6 g/m2; P = 0.02; 100 +/- 20.2 versus 80 +/- 9.7 milliseconds; P = 0.001, respectively). Exercise capacity in metabolic equivalents was similar in both groups. Systolic BP response during exercise and recovery were similar in both groups. Diastolic BP decreased during exercise, but the magnitude of decrease was lower in patients with ADPKD than controls (P = 0.01). During recovery, patients with ADPKD showed a greater sustained diastolic BP than controls (P = 0.02). Patients with ADPKD with an exaggerated systolic BP response had a greater LVM index than those with a normal response (112.1 +/- 10.4 versus 84 +/- 19.2 g/m2; P = 0.001). Multivariate regression analysis showed that exercise systolic BP and diastolic BP were independent predictors of LVM index and IVRT, respectively. CONCLUSION: Young normotensive patients with ADPKD showed increased LVM index and prolonged IVRT, which are related to exercise BP response. Exaggerated diastolic BP response during exercise suggests an impaired capacity for exercise-induced vasodilatation and may indicate a greater risk for the development of future hypertension.
Authors:
Alberto Martinez-Vea; Alfredo Bardaj; Cristina Gutierrez; Carmen Garca; Carmen Peralta; Luis Marcas; Jesús Angel Oliver
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  44     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-07-20     Completed Date:  2005-01-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  216-23     Citation Subset:  IM    
Affiliation:
Nephrology Service, Hospital Universitari de Tarragona Joan XXIII, Tarragona, Spain. amtz@hjxxiii.scs.es
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure / physiology*
Case-Control Studies
Diastole / physiology*
Disease Susceptibility
Echocardiography, Doppler, Color
Exercise*
Exercise Test
Exercise Tolerance
Female
Heart Rate
Humans
Hypertension / epidemiology
Hypertrophy, Left Ventricular / etiology,  pathology,  physiopathology,  ultrasonography
Life Style
Male
Myocardium / pathology*
Polycystic Kidney, Autosomal Dominant / pathology,  physiopathology*
Risk Factors
Smoking / epidemiology
Vasodilation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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