Risk of Ascending Aortic Aneurysm in Patients With Autosomal Dominant Polycystic Kidney Disease

• Published in: The American journal of cardiology Vol. 123; no. 3; pp. 482 - 488
• Main Authors: Bouleti, Claire, Flamant, Martin, Escoubet, Brigitte, Arnoult, Florence, Milleron, Olivier, Vidal-Petiot, Emmanuelle, Langeois, Maud, Ou, Phalla, Vrtovsnik, François, Jondeau, Guillaume
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2019; Elsevier Limited; Elsevier
• Subjects: Age; Aneurysms; Aorta; Aortic aneurysms; Beta blockers; Blood pressure; Cardiovascular disease; Coronary vessels; Cysts; Diabetes; Diastole; Dilation; Dissection; Echocardiography; Enzymes; Hypertension; Kidney diseases; Kidneys; Life Sciences; Patients; Polycystic kidney; Sex; Sinuses; Variables
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2018.10.030

In recent years, simple renal cysts have been associated with an increased risk of aortic aneurysms. There is little data regarding aortic dilation in patients with autosomal dominant polycystic kidney disease (ADPKD). The aim of this study was to compare Sinuses of Valsalva (SoV) and tubular ascending aorta diameters in ADPKD patients with matched controls. From 2008 to 2016, 61 consecutive ADPKD patients who had an echocardiogram performed in our institution were matched 1:1 with controls for sex, age, blood pressure, and β-blocker therapy use. SoV and tubular ascending aorta were measured at end-diastole, using the leading-edge to leading-edge convention. Paired t Tests were used for quantitative variables and McNemar-tests for qualitative variables. The mean age of patients was 56 ± 12 years, 54% were men, 38% received β-blockers, and mean systolic and diastolic BP were 137 ± 25 and 78 ± 19 mm Hg. SoV diameters were significantly larger in ADPKD patients than in controls (36.4 ± 4.1 vs 34.0 ± 3.7 mm, p <0.0001). The Z-scores (normalized for sex, age, and body surface area) were significantly higher in ADPKD patients, both for SoV and tubular ascending aorta. Moreover, aortic aneurysms, as defined by a Z score >2 standard deviations, were present in 27 ADPKD patients (44%) versus 9 controls (15%, p <0.001). In conclusion, there is an increased prevalence of aortic aneurysms in ADPKD patients as compared with controls matched for common confounding factors for aortic dilation.