Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Original Paper Kidney Blood Press Res 2007;30:234–239 DOI: 10.1159/000104092 Diastolic Function in Several Stages of Chronic Kidney Disease in Patients with Autosomal Dominant Polycystic Kidney Disease: A Tissue Doppler Imaging Study Edgar A.F. de Almeida a Eduardo I. de Oliveira b José António Lopes a Ana G. Almeida b Mário G. Lopes b M. Martins Prata a a Serviço de Nefrologia e Transplantação Renal, b Serviço de Cardiologia, Hospital de Santa Maria, Lisboa, Portugal gressively as renal function deteriorates in patients with ADPKD and this effect is independently related to age and blood pressure. Copyright © 2007 S. Karger AG, Basel Introduction Cardiovascular disease is the main cause of death in patients with autosomal dominant polycystic kidney dis- ease (ADPKD) [1]. Contributing factors are early occur- rence of hypertension [2], insulin resistance [3], increased left ventricular mass [4], and probably, diastolic dysfunc- tion [5]. Diastolic dysfunction is a state of impaired dis- tensibility, relaxation or filling of the left ventricle that may predispose to diastolic heart failure [6]. Few studies have addressed the diastolic function in patients with ADPKD [5, 7, 8]. In normotensive young adults with ADPKD, diastolic dysfunction is not a prom- inent sign [8]. However, when study population includes older patients or patients with less strict inclusion criteria, diastolic dysfunction becomes more apparent [7] . There- fore, it is reasonable to assume that as renal function de- teriorates, or in older patients, where hypertension is more prevalent, diastolic dysfunction emerges more clearly. Key Words Diastolic dysfunction  Chronic kidney disease  Autosomal dominant polycystic kidney disease  Tissue Doppler imaging study Abstract Background: This study evaluates the prevalence of diastol- ic dysfunction (DD) in several stages of chronic kidney dis- ease (CKD) in patients with autosomal dominant polycystic kidney disease (ADPKD). Methods: 107 ADPKD patients per- formed echocardiographic and Doppler studies and a tissue Doppler imaging (TDI) study. Patients were divided in three groups: group 1, 57 patients with CKD stage I, group 2, 37 patients in stages II and III, and group 3, 13 patients with CKD stages IV and V (not on dialysis). Results: In transmitral Doppler, 1 patient in group 1 compared to 5 in group 2, and 4 in group 3 exhibited DD (p ! 0.005); moreover, E/A ratio decreases progressively from group 1 to 3 (p ! 0.0001). In TDI, DD was observed in 8 patients in group 1, 17 in group 2, and 8 in group 3 had DD (p ! 0.001). Em velocity, the best TDI parameter for DD, correlated with age, renal function and blood pressure. When adjusted for age, increased left ven- tricular mass index and decreased renal function were inde- pendent risk factors of DD. Conclusions: DD occurred pro- Received: September 12, 2006 Accepted: April 22, 2007 Published online: June 15, 2007 Dr. Edgar de Almeida Av. Prof. Egas Moniz PT–1639-045 Lisboa (Portugal) Tel. + 351 217 805 317, Fax +351 217 805 679 E-Mail edealmeida@mail.telepac.pt © 2007 S. Karger AG, Basel 1420–4096/07/0304–0234$23.50/0 Accessible online at: www.karger.com/kbr