2014, Number 3
Correlation between the Degree of Left Ventricular Dysfunction and Serum Uric Acid Levels
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Language: Spanish
References: 16
Page: 276-284
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ABSTRACT
Background: Congestive heart failure can be defined as an abnormality of structure or function that leads to deficiency of the heart to supply oxygen at a rate in accordance with the requirements of metabolizing tissue, despite normal pressures of filling. Left ventricular ejection fraction is defined as the stroke volume divided by end-diastolic volume of the relevant ventricular chamber. Whereas more severe is systolic dysfunction, more reduced ejection fraction and higher volumes are at the end of the systole and diastole. It has been published a consensus on the importance of the assessment of diastolic dysfunction in patients with heart failure with preserved EF (HF-SCF). Many epidemiological studies are associated with increased serum uric acid with increasing range cardiovascular events and mortality in those with known or high risk of vascular disease and from healthy volunteers. There is strong evidence supporting the role of xanthine oxidase pathway in heart failure.Objective: To correlate uric acid levels with different degrees of cardiac dysfunction and the percentage of ejection fraction in patients with congestive heart failure.
Patients and method: A descriptive, observational, transversal analytic and retrolective study was done with a sample of 24 patients diagnosed with heart failure that had undergone echocardiography and suffered both diastolic and systolic left ventricular dysfunction. We collected data as patient's age, sex and uric acid levels. Nominal and numeric variables were expressed in frequency using measures of central tendency and dispersion. We used Pearson correlation coefficient and linear correlation. To evaluate the association of qualitative variables χ2 was used. Statistical significance was considered a confidence level of 95% and an α of .05.
Results: Negative correlation was found between uric acid level and LVEF% with r = - 0.71 and p ‹ 0.01. The OR (odds ratio) indicated that hyperuricemia is a risk factor for heart failure: OR = 6.4 (95% CI 1.09, 37.7). We observed a difference between hyperuricemia and no hyperuricemia in case of heart failure. There was an association between diastolic dysfunction and hyperuricemia: X2 = 5.23, p ‹ 0.05. The OR indicated that hyperuricemia is a risk factor for diastolic dysfunction: OR = 8 (95% CI 1.21, 52.6). We noted the difference in the presence of diastolic dysfunction with hyperuricemia vs without hyperuricemia.
Conclusions: There is a statistically significant negative correlation between the serum uric acid and percentage of left ventricular ejection fraction, as well as a relation between hyperuricemia and heart failure development and between hyperuricemia and diastolic dysfunction, compared with subjects who did not have hyperuricemia.
REFERENCES
The task force for the diagnosis and treatment of acute and chronic heart failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. Eur Heart J 2012;33;1787-1847.
Grupo de trabajo de la ESC para el diagnóstico y tratamiento de la insuficiencia cardiaca aguda y crónica 2008. Desarrollado en colaboración con la Heart Failure Association (HFA) de la ESC y aprobado por la European Society of Intensive Care Medicine (ESICM). Guía de práctica clínica de la Sociedad Europea de Cardiología (ESC) para el diagnóstico y tratamiento de la insuficiencia cardiaca aguda y crónica 2008. Rev Esp Cardiol 2008;61:1329.
Jessup M, Abraham WT, Casey DE, et al. 2009 Focused Update: ACCF/AHA Guidelines for the diagnosis and management of heart failure in adults: A report of the American College of Cardiology Foundation/American Heart Association task force on Practice Guidelines: Developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation 2009;119:1977-2016.