Serum uric acid levels correlate with filling pressures in systolic heart failure

The authors studied the relationship between liver function tests and serum uric acid level with clinical and hemodynamic profiles in heart failure. Fifty patients (aged 44±15 years; 74.5% men) with an ejection fraction (EF) <35% were enrolled and clinical assessment was performed. Hemodynamic indices (including pulmonary arterial pressure [PAP], pulmonary capillary wedge pressure [PCWP], and cardiac index were studied by standard Edwards Lifesciences Swan-Ganz catheters, and liver function tests and serum uric acid level were measured simultaneously. Fifty age- and sex-matched controls with normal EF were also studied. A total of 73% of patients had ischemic cardiomyopathy. Mean uric acid level was 7.2±3.8 mg/dL and was significantly higher than in the control group (P value<.001). In multivariate analysis, uric acid correlated significantly with PAP (r=.5, P<.001) and PCWP (r=.4, P=.002) and was also associated with clinical signs of rales, edema, paroxysmal nocturnal dyspnea (r=.5, P=.01), and New York Heart Association class (r=.4, P=.005). Uric acid level was also correlated inversely with left ventricular EF (r=.27, P=.006). Elevated uric acid levels in patients with systolic heart failure is associated with impaired clinical and hemodynamic profile and might be used as a noninvasive indicator of elevated left ventricular filling pressures.