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Impact of gout on left atrial function: a prospective speckle-tracking echocardiographic study

Kuo-Li Pan1, Jing-Chi Lin2, Chun-Liang Lin3

  • 1Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan; The Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan.

Plos One
|September 25, 2014
PubMed

Insights

Gout negatively impacts heart function, causing diastolic and subclinical systolic dysfunction in the left ventricle (LV) and impairing left atrial (LA) reservoir, conduit, and booster pump functions, particularly in advanced stages.

Area of Science:

  • Cardiology
  • Rheumatology
  • Echocardiography

Background:

  • Gout is a common inflammatory arthritis associated with various comorbidities.
  • Cardiac involvement in gout is increasingly recognized but not fully understood.
  • Evaluating left ventricular (LV) and left atrial (LA) function in gout patients is crucial.

Purpose of the Study:

  • To assess LV and LA function in patients with different stages of gout.
  • To identify echocardiographic parameters affected by gout severity.

Main Methods:

  • A comprehensive Doppler-echocardiography examination was performed on 173 patients.
  • Participants were categorized into four groups: control, asymptomatic hyperuricemia, gouty arthritis without tophi, and tophaceous gout.
  • Serum uric acid levels and various echocardiographic parameters were analyzed.

Main Results:

  • Tophaceous gout patients showed impaired LV diastolic function (higher E/Em ratio) and reduced LV global longitudinal systolic strain (LVε).
  • Significant reductions in left atrial (LA) function, including reservoir, conduit, and booster pump function (decreased ALSR(syst), ALSR(early), ALSR(late)), were observed in tophaceous gout.
  • Increased maximal LA volume index (LAVi) was noted in Stage III patients compared to controls.

Conclusions:

  • Gout leads to left ventricular diastolic dysfunction and subclinical systolic dysfunction.
  • Gout significantly impairs left atrial reservoir, conduit, and booster pump functions.
  • Gout severity independently impacts left atrial pump function, highlighting the systemic effects of the disease.

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