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Elevated serum uric acid levels are associated with diastolic dysfunction in patients with dilated cardiomyopathy
Mariantonietta Cicoira1, Luisa Zanolla, Andrea Rossi
1Divisione Clinicizzata di Cardiologia, Università degli Studi di Verona, Italy. mariantonietta.cicoira@univr.it
Insights
Elevated serum uric acid is linked to diastolic dysfunction in chronic heart failure (CHF) patients. This suggests potential benefits of xanthine oxidase inhibition for improving cardiac diastolic function in this population.
Area of Science:
- Cardiology
- Metabolic Disorders
- Biomarkers
Background:
- Serum uric acid is frequently elevated in chronic heart failure (CHF) and linked to vascular resistance.
- The impact of elevated uric acid on cardiac function in CHF patients remains unevaluated.
Purpose of the Study:
- To investigate the correlation between serum uric acid levels and left ventricular systolic and diastolic dysfunction in patients with CHF.
Main Methods:
- 150 outpatients with CHF underwent comprehensive echo-Doppler examinations.
- Measurements included mitral inflow velocities (E/A ratio, deceleration time), left ventricular volumes, ejection fraction, and stroke volume.
- A restrictive mitral filling pattern (RMFP) was defined using specific E/A ratio and deceleration time criteria.
Main Results:
- Patients with RMFP exhibited significantly higher serum uric acid levels compared to those without (0.48 vs. 0.38 mmol/L).
- Serum uric acid correlated significantly with mitral E wave velocity, E/A ratio, deceleration time, and RMFP.
- Multivariate analysis indicated that uric acid independently predicted E wave deceleration time, irrespective of renal function or diuretic use.
Conclusions:
- Elevated serum uric acid levels are associated with diastolic dysfunction in patients with CHF.
- Xanthine oxidase inhibition may offer a theoretical therapeutic strategy to improve diastolic function in CHF.
Objective:
To assess whether serum uric acid, which is a marker of impaired oxidative metabolism, might correlate with left ventricular systolic and diastolic dysfunction in patients with chronic heart failure (CHF).
Background:
Uric acid levels, which are frequently elevated in patients with CHF, correlate with leg vascular resistance. The effects of elevated levels of uric acid on cardiac function in patients with CHF have never been evaluated.
Methods:
We studied 150 outpatients with CHF who came to our heart failure clinic. Patients underwent a complete echo-Doppler examination, with measurement of mitral E wave and mitral A wave velocities, E/A ratio, E wave deceleration time (DtE), left ventricular volumes, ejection fraction, and stroke volume. A restrictive mitral filling pattern (RMFP) was defined as either E/A ratio >2 or E/A >1 and DtE <140 milliseconds.
Results:
Mean age was 62.2 +/- 7.8 years (86% male); 24 patients (16%) had an RMFP. Patients with an RMFP had significantly higher uric acid levels compared with patients without RMFP (0.48 +/- 0.14 mmol/L vs 0.38 +/- 0.08 mmol/L, respectively, P <.001). Uric acid levels correlated significantly with mitral E wave velocity (r =.22, P <.01), E/A ratio (r =.21, P <.05), DtE (r =.26, P <.01), and RMFP (P =.0001). There was no correlation between uric acid and left ventricular volumes, ejection fraction, or stroke volume. In a multivariate model, uric acid predicted DtE independently of renal function, diuretic dose, and left ventricular volumes.
Conclusion:
Elevated uric acid levels are associated with diastolic dysfunction in CHF. Xanthine oxydase inhibition in patients with CHF might theoretically result in an improvement of diastolic function.