Haemodynamic correlates and prognostic significance of serum uric acid in adult patients with Eisenmenger syndrome

Abstract

Objective-To assess haemodynamic correlates and prognostic significance of serum uric acid in adult patients with Eisenmenger syndrome. Design-Retrospective observational study. Setting-Tertiary referral centre. Patients-94 adult patients with Eisenmenger syndrome who were diagnosed between September 1982 and July 1998. Main outcome measures-Serum uric acid was measured in all patients, together with clinical and haemodynamic variables related to mortality. Results-Serum uric acid was raised in patients with Eisenmenger syndrome compared with age and sex matched control subjects (7.0 v 4.7 mg/dl, p < 0.0001) and increased in proportion to the severity of New York Heart Association functional class. Serum uric acid was positively correlated with mean pulmonary arterial pressure (r = 0.30, p = 0.0052) and total pulmonary resistance index (r = 0.55, p < 0.0001), and negatively correlated with cardiac index (r = −0.50, p < 0.0001). During a mean follow up period of 97 months, 38 patients died of cardiopulmonary causes. Among various clinical, echocardiographic, and laboratory variables, serum uric acid remained predictive in multivariate analysis. Kaplan-Meier survival curves based on median serum uric acid showed that patients with high values had a significantly worse survival rate than those with low values (log-lank test: p = 0.0014 in male patients, p = 0.0034 in female patients). Conclusions-Serum uric acid increases in proportion to haemodynamic severity in adult patients with Eisenmenger syndrome and is independently associated with long term mortality. (Heart 2000;84:53-58)

The challenge of managing pulmonary arterial hypertension in adults with congenital heart disease

“…In ES patients, higher functional class, a history of arrhythmias, patient age, right ventricular dysfunction, syncope, elevated uric acid levels and the presence of Down's syndrome have been found to be of value in predicting a poor outcome [26,[30][31][32][33][34]. In a very recent study based on data of 181 ES patients, a composite echocardiographic score was also highly predictive of clinical outcome [35].…”

Clinical Evaluation and Management of Pulmonary Hypertension in the Adult With Congenital Heart Disease

“…30,31 Many predictors of outcome overlap with those in PAH patients without CHD: cardiac index, right atrial pressure, uric acid, 6-minute walk distance, and B-type natriuretic peptide. 21,22,32 …”

Serum Uric Acid as a Prognostic Predictor in Pulmonary Arterial Hypertension With Connective Tissue Disease

“…14) Moreover, the serum uric acid concentration is closely correlated with the severity of symptoms and mortality in patients with idiopathic PAH 15) or Eisenmenger syndrome. 16) However, the association between serum UA levels and long-term outcome in PAH secondary to connective tissue disease has not been evaluated. The present study examines whether serum UA levels are related to the mortality of patients with PAH secondary to connective tissue disease.…”