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Abstract：
OBJECTIVE: Renin-angiotensin system hyperactivation in autosomal-dominant polycystic kidney disease (ADPKD) patients leads to early hypertension. Cystic enlargement probably causes parenchymal hypoxia, renin secretion, and endothelial dysfunction. Sympathetic and parasympathetic balance is altered in this condition, especially during the night, also affecting blood pressure circadian rhythm. Aim of this study was to evaluate sympathetic/parasympathetic balance using heart rate variability (HRV) parameters and find a correlation between HRV and renal damage progression, as total kidney volume enlargement, in ADPKD patients.
METHODS: Sixteen adult ADPKD patients were enrolled in the study. Eleven patients (68.8%) were male, and the median age was 42 years (IQR 36-47.5). HRV parameters were calculated using 24 h-ECG Holter. A kidney magnetic resonance imaging (MRI) scan 3 Tesla was performed to evaluate total kidney volume (TKV) and total fibrotic volume (TFV).
RESULTS: A statistically significant positive linear correlation was observed between length of kidneys and frequency domain parameters as low frequency (LF) (r = 0.595, p < 0.05) and LFday (r = 0.587, p < 0.05). Moreover, a statistically significant positive linear correlation exists between high frequency (HF) and TFV (r = 0.804, p < 0.01) or height-adjusted (ha) TFV (r = 0.801, p < 0.01). Finally, we found a statistically significant positive linear correlation between HFnight and TKV (r = 0.608, p < 0.05), ha-TKV (r = 0.685, p < 0.01), TFV (r = 0.594, p < 0.05), and ha-TFV (r = 0.615, p < 0.05).
CONCLUSIONS: We suppose that the increase in TKV and TFV could lead to a parasympathetic tone hyperactivation, probably in response to hypoxic stress and vasoconstriction due to cystic enlargement.
METHODS: Sixteen adult ADPKD patients were enrolled in the study. Eleven patients (68.8%) were male, and the median age was 42 years (IQR 36-47.5). HRV parameters were calculated using 24 h-ECG Holter. A kidney magnetic resonance imaging (MRI) scan 3 Tesla was performed to evaluate total kidney volume (TKV) and total fibrotic volume (TFV).
RESULTS: A statistically significant positive linear correlation was observed between length of kidneys and frequency domain parameters as low frequency (LF) (r = 0.595, p < 0.05) and LFday (r = 0.587, p < 0.05). Moreover, a statistically significant positive linear correlation exists between high frequency (HF) and TFV (r = 0.804, p < 0.01) or height-adjusted (ha) TFV (r = 0.801, p < 0.01). Finally, we found a statistically significant positive linear correlation between HFnight and TKV (r = 0.608, p < 0.05), ha-TKV (r = 0.685, p < 0.01), TFV (r = 0.594, p < 0.05), and ha-TFV (r = 0.615, p < 0.05).
CONCLUSIONS: We suppose that the increase in TKV and TFV could lead to a parasympathetic tone hyperactivation, probably in response to hypoxic stress and vasoconstriction due to cystic enlargement.
摘要：
目的：常染色体显性遗传多囊肾病（ADPKD）患者肾素-血管紧张素系统过度激活导致早期高血压。囊性肿大可能导致实质缺氧，肾素分泌,和内皮功能障碍。在这种情况下，交感神经和副交感神经的平衡会改变，尤其是在夜晚,也影响血压昼夜节律。这项研究的目的是使用心率变异性（HRV）参数评估交感神经/副交感神经平衡，并发现HRV与肾损害进展之间的相关性。随着肾脏总体积的增大，ADPKD患者。
方法：16例成人ADPKD患者纳入研究。11例（68.8%）为男性，中位年龄为42岁(IQR36-47.5).使用24h-ECGHolter计算HRV参数。进行3特斯拉的肾脏磁共振成像（MRI）扫描以评估总肾脏体积（TKV）和总纤维化体积（TFV）。
结果：在肾脏长度与低频（LF）（r=0.595，p<0.05）和LFday（r=0.587，p<0.05）的频域参数之间观察到具有统计学意义的正线性相关。此外，高频（HF）与TFV（r=0.804，p<0.01）或高度调整（ha）TFV（r=0.801，p<0.01）之间存在统计学上的正线性相关。最后,我们发现HFnight和TKV之间存在统计学上显著的正线性相关(r=0.608,p<0.05),ha-TKV(r=0.685，p<0.01)，TFV(r=0.594，p<0.05)，和ha-TFV(r=0.615，p<0.05)。
结论：我们假设TKV和TFV的增加可能导致副交感神经张力过度激活，可能是对由于囊性肿大引起的低氧压力和血管收缩的反应。
方法：16例成人ADPKD患者纳入研究。11例（68.8%）为男性，中位年龄为42岁(IQR36-47.5).使用24h-ECGHolter计算HRV参数。进行3特斯拉的肾脏磁共振成像（MRI）扫描以评估总肾脏体积（TKV）和总纤维化体积（TFV）。
结果：在肾脏长度与低频（LF）（r=0.595，p<0.05）和LFday（r=0.587，p<0.05）的频域参数之间观察到具有统计学意义的正线性相关。此外，高频（HF）与TFV（r=0.804，p<0.01）或高度调整（ha）TFV（r=0.801，p<0.01）之间存在统计学上的正线性相关。最后,我们发现HFnight和TKV之间存在统计学上显著的正线性相关(r=0.608,p<0.05),ha-TKV(r=0.685，p<0.01)，TFV(r=0.594，p<0.05)，和ha-TFV(r=0.615，p<0.05)。
结论：我们假设TKV和TFV的增加可能导致副交感神经张力过度激活，可能是对由于囊性肿大引起的低氧压力和血管收缩的反应。
