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Association Between Family History in Patients with Primary Gout and Left Ventricular Diastolic Function: A
Wen Wen1, Ping Lei1, Wantai Dang2
1Department of Ultrasound, First Affiliated Hospital, Clinical Medical College of Chengdu Medical College, Chengdu, People's Republic of China.
Insights
A family history of gout is linked to impaired left ventricular (LV) diastolic function in primary gout patients. Combining family history with serum uric acid (SUA) levels can help identify severe LV diastolic insufficiency.
Area of Science:
- Cardiology
- Rheumatology
- Genetics
Background:
- Gout is a common metabolic disease.
- Left ventricular (LV) diastolic dysfunction is an early indicator of cardiac involvement in gout.
- The impact of a family history of gout on LV diastolic function requires further investigation.
Purpose of the Study:
- To investigate the association between a family history of gout and LV diastolic function in patients with primary gout.
- To identify echocardiographic markers of LV diastolic function affected by a family history of gout.
- To evaluate the utility of family history and serum uric acid (SUA) in predicting severe LV diastolic insufficiency.
Main Methods:
- Echocardiography was used to measure LV diastolic function parameters in 284 primary gout patients.
- Patients' family history of gout, demographics, and laboratory markers were recorded.
- Regression and receiver operating characteristic (ROC) curve analyses were performed to assess correlations.
Main Results:
- Patients with a family history of gout exhibited significantly lower LV diastolic function parameters (e.g., E/A, e') and higher left atrial volume index (LAVI) and E/e' compared to those without.
- The prevalence of grade ≥2 LV diastolic insufficiency was higher in patients with a family history of gout (41.6% vs 12.3%).
- Family history of gout was independently associated with LV diastolic function markers, and ROC analysis showed family history combined with SUA level had an area of 0.872 for predicting grade ≥2 LV diastolic insufficiency.
Conclusions:
- A family history of gout is significantly associated with echocardiographic markers of LV diastolic dysfunction in primary gout patients.
- Family history of gout is a crucial factor influencing LV diastolic function.
- Combining family history of gout with SUA levels provides a valuable tool for identifying patients with significant LV diastolic insufficiency.
Objective:
This study aimed to employ echocardiography for measuring the markers of left ventricular (LV) diastolic function to investigate the effects of family history of gout on the LV diastolic function in patients with primary gout.
Methods:
Two hundred and eighty-four patients with primary gout who visited the Department of Rheumatology and Immunology of the First Affiliated Hospital of Chengdu Medical College from September 2020 to July 2022 were selected and their family history of gout, general information, and laboratory markers were recorded. Parameters of LV diastolic function were measured via echocardiography. The correlation between family history and LV diastolic function markers was analyzed using univariate and multivariate regression and the receiver operating characteristic (ROC) curve analyses.
Results:
LV diastolic function parameters, peak early mitral diastolic velocity (E)/peak late mitral diastolic velocity (A), and early septal mitral annulus diastolic motion velocity (Sepe'), early lateral mitral annulus diastolic motion velocity (Late') and their mean (e'), were significantly lower in patients with familial primary gout, while left atrial volume index (LAVI) and E/e' were markedly elevated in patients with sporadic primary gout. In patients with family history, the proportion of grade ≥2 LV diastolic insufficiency was distinctly higher than that in patients without family history (41.6% vs 12.3%). Even after adjusting for confounding variables, LAVI, E/A, Sepe', Late', e', E/e' were obviously associated with family history of gout. The area under ROC of family history combined with SUA level for identifying grade ≥2 LV diastolic insufficiency in patients with primary gout was 0.872 (P<0.05).
Conclusion:
Family history of gout was closely related to echocardiographic LV diastolic function parameters in patients with gout, what is more, family history of gout combined with SUA level was found to be a valuable indicator for discriminating grade ≥2 LV diastolic insufficiency in patients with primary gout.
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