Clinical Investigations: Congestive Heart FailureElevated serum uric acid levels are associated with diastolic dysfunction in patients with dilated cardiomyopathy☆,☆☆
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Study population
We studied 150 consecutive patients in a stable clinical status at our outpatient heart failure clinic. Each patient had a left ventricular ejection fraction (LVEF) <45% and a duration of heart failure of at least 6 months, was on standard therapy for heart failure and on optimal diuretic dose. Patients in atrial fibrillation were excluded from the study because an adequate echocardiographic evaluation of diastolic function requires sinus rhythm. On the day of the study, fasting venous blood
Results
The clinical characteristics of the study population are summarized in Table I.Parameter Mean ± SD (range) Age (y) 62.2 ± 7.8 (31-82) Male sex (%) 144 (86) Ischemic etiology (%) 111 (66) NYHA class 2.3 ± 0.7 (1-4) S-potassium (mEq/L) 4.5 ± 3.0 (3.6-5.2) S-sodium (mEq/L) 139 ± 2 (129-145) S-creatinine (μmol/L) 106 ± 38 (49-198) S-uric acid (mmol/L) 0.4 ± 0.1 (0.2-0.8) S-cholesterol (mmol/L) 5.2 ± 0.8 (3.4-8.2) S-triglycerides (mmol/L) 2.0 ± 1.2 (0.4-6.7) Peak VO2 (mL/min/kg)
Discussion
This is the first study to evaluate the effects of elevated uric acid levels on cardiac function. We found a significant relationship between serum uric acid and parameters of diastolic function. On the other hand, urate levels did not correlate with markers of systolic function or with left ventricular volumes.
Markers of diastolic dysfunction are frequent in patients with CHF.11 Severe diastolic dysfunction is characterized by an RMFP and is associated with severity of symptoms,12 functional
Acknowledgements
We thank Christine Harris for revising the English manuscript.
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Reprint requests: Mariantonietta Cicoira, MD, Divisione Clinicizzata di Cardiologia, Ospedale Civile Maggiore, P.le Stefani, 1 37126 Verona- Italy.
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E-mail: [email protected]