Hyperuricemia is an Independent Predictive Factor for
Left Ventricular Diastolic Dysfunction in Patients with
Chronic Kidney Disease

Gromadziński, Leszek; Januszko‐Giergielewicz, Beata; Pruszczyk, Piotr

doi:10.17219/acem/38159

Cited by 17 publications

(12 citation statements)

References 35 publications

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“…Association between serum UA and EF is still controversial. Some studies showed negatively correlations (28,29) others did not found any correlation (26,27,28). In the present study a positive correlation was observed between UA and EF, (p<0.05 in the presence of obesity).…”

Section: Discussion:-supporting

confidence: 48%

“…Patients with congestive heart failure (HF) and increasing filling pressures had significantly higher serum UA levels and serum UA levels correlated with echocardiographic parameters of diastolic function (24). Patients with gouty tophi had a significantly thicker LV interventricular septum and posterior wall and increased LA volume index reflecting LV diastolic dysfunction (25) Hyperuricemia is an independent predictive factor for LV diastolic dysfunction also in patients with chronic kidney disease (26). Findings of these studies are consistent with our results in lean controls in whom serum UA correlated with parameters of LV structure and LV diastolic function but not with LV volumes.…”

Section: Discussion:-mentioning

confidence: 99%

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Role of Uric Acid in Cardiac Changes in Overweight and Obese Children

Schusterova¹,

Banovcinova²,

Takacova³

et al. 2019

IJAR

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Background: High serum uric acid (UA) levels appear to contribute to an increase in blood pressure (BP) in obese adolescents and may amplify the cardiac volume overload effects of obesity with pressure overload. Association between UA and ejection fraction (EF) is still controversial. Some studies showed negatively correlations, others did not found any correlation. So far, no data have been published regarding the influence of UA levels on structural and functional changes of the LV in children with obesity. Objective: The aim of our study was to assess the influence of UA levels on LV structure and function in overweight/obese children. Study groups and methods: In 25 (mean age 13.0 ± 2.3) overweight/obese subjects and 24 lean controls, BP, fasting plasma glucose, insulin, and UA were measured. LV structural and functional parameters were measured by echocardiography. Results: In overweight/obese children UA correlates with LV diastolic volumes and LV systolic function but not with LVM whereas in children without obesity UA correlates with LVM and LV diastolic function. Conclusion: The present study demonstrates a positive correlation of UA with EF and left atrium and LV volume in volume overload due to obesity in children. These conclusions require further investigation.

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Section: Discussion:-supporting

confidence: 48%

Section: Discussion:-mentioning

confidence: 99%

Role of Uric Acid in Cardiac Changes in Overweight and Obese Children

Schusterova¹,

Banovcinova²,

Takacova³

et al. 2019

IJAR

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“…Shimizu and colleagues also suggested that hyperuricemia was associated with arterial stiffness, impaired exercise capacity, and high mortality in HFpEF. Moreover, Serum UA level was shown to be associated with LV diastolic dysfunction . It was reported that among cardiac patients with preserved ejection fraction, serum UA level was significantly associated with diastolic dysfunction in women .…”

Section: Discussionmentioning

confidence: 94%

“…Moreover, Serum UA level was shown to be associated with LV diastolic dysfunction. [19][20][21] It was reported that among cardiac patients with preserved ejection fraction, serum UA level was significantly associated with diastolic dysfunction in women. 20 Also, Tang and colleagues 21 analyzed data from patients who had preserved LVEF and reported that UA was associated with diastolic HF.…”

Section: Discussionmentioning

confidence: 99%

Serum uric acid is associated with incidence of heart failure with preserved ejection fraction and cardiovascular events in patients with arterial hypertension

Fan

Zhang

et al. 2018

J of Clinical Hypertension

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The objective of the present study was to evaluate clinical implications of serum uric acid (UA) on the progression of heart failure with preserved ejection fraction (HFpEF) in hypertensive patients. A total of 1009 adult patients with left ventricular hypertrophy and suspected left ventricular diastolic dysfunction were enrolled at our hospital from January 2008 to December 2011. With a median follow‐up of 7.2 years, 136 (13.2%) patients developed new‐onset HFpEF and 151 (15.0%) had major adverse cardiovascular events (MACEs). Compared with the lowest UA tertile of UA (<302 μmol L−1), subjects in the highest tertile (>367 μmol L−1) had a higher risk of developing new‐onset HFpEF (HR: 1.761, 95% CI: 1.119‐2.772, P = .015) as well as MACEs (HR: 1.664, 95% CI: 1.086‐2.547, P = .019). Our findings indicate that hyperuricemia is associated with detrimental effects in terms of the incidence of new‐onset HFpEF as well as MACEs in hypertensive patient.

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“…In addition, several recent studies demonstrated, albeit by analyzing relatively small sample sizes, that elevated SUA may be associated with increased risk of LV diastolic dysfunction among a selected population (13,38). Of note, the finding that a xanthine oxidase inhibitor that decreased SUA level also improved cardiac diastolic relaxation in mice fed a Western diet suggested that SUA might be a modifiable factor associated with diastolic dysfunction.…”

mentioning

confidence: 99%

Serum uric acid is associated with cardiac diastolic dysfunction among women with preserved ejection fraction

Nogi

Fujita

Okamoto

et al. 2015

American Journal of Physiology-Heart and Circulatory Physiology

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N. Serum uric acid is associated with cardiac diastolic dysfunction among women with preserved ejection fraction. Am J Physiol Heart Circ Physiol 309: H986 -H994, 2015. First published July 25, 2015 doi:10.1152/ajpheart.00402.2015.-Serum uric acid (SUA) is associated with the severity and prognosis of systolic heart failure. We investigated the potential association between SUA and cardiac diastolic dysfunction among total of 744 cardiac patients (202 women and 542 men) who had preserved left ventricular ejection fraction. Presence of diastolic dysfunction was assessed by echocardiographic data, plasma B-type natriuretic peptide concentration, and left ventricular hypertrophy. Univariate analysis showed that the prevalence of diastolic dysfunction increased with increasing SUA value in women, but not in men. When sex-nonspecific SUA quartiles were used, multivariate logistic regression analysis, among female patients who were not taking uric acid lowering medication, showed that the third (SUA, 5.7-6.4 mg) and the fourth (SUA, Ն6.5 mg/dl) SUA quartiles were associated with diastolic dysfunction with an odds ratio of 3.25 (P Ͻ 0.05) and 8.06 (P Ͻ 0.001), respectively, when compared with the first SUA quartile (Յ4.7 mg/dl). When sex-specific SUA quartiles were used among these population, multivariate logistic regression analysis showed that the fourth SUA quartile (Ն5.7 mg/dl) was associated with diastolic dysfunction with an odds ratio of 5.34 (P Ͻ 0.05) when compared with the first SUA quartile (Յ4.1 mg/dl). By contrast, the relationship between SUA and diastolic dysfunction was not significant in men, irrespective of which of the sex-nonspecific or sex-specific SUA quartiles were used. These data indicated that among cardiac patients with preserved ejection fraction, SUA was significantly associated with diastolic dysfunction in women but not in men. ALONGSIDE THE AGING POPULATION, the prevalence of heart failure with preserved ejection fraction, or diastolic heart failure, is increasing, and this increase is more prominent in women than in men, who demonstrate striking disparity with regard to heart failure with reduced ejection fraction (2,3,25). This disparity might be explained by the fact that aging-associated concentric ventricular remodeling is greater in the female heart (35). In addition to sex difference, several clinical characteristics are known to be associated with heart failure with preserved ejection fraction including older age, hypertension, obesity, diabetes, and potassium concentration (23). The prognosis for diastolic heart failure may be as poor as that for systolic heart failure (11, 31), and most therapies that have been shown to be effective for systolic heart failure seem to be least effective for diastolic heart failure (11,15,26,32,42). Thus factors that are not only related to diastolic dysfunction risk but also potentially modifiable by lifestyle interventions or certain medication need to be identified for the better management of diastolic cardiac dysfunction, especially in wom...

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Hyperuricemia is an Independent Predictive Factor for Left Ventricular Diastolic Dysfunction in Patients with Chronic Kidney Disease

Cited by 17 publications

References 35 publications

Role of Uric Acid in Cardiac Changes in Overweight and Obese Children

Role of Uric Acid in Cardiac Changes in Overweight and Obese Children

Serum uric acid is associated with incidence of heart failure with preserved ejection fraction and cardiovascular events in patients with arterial hypertension

Serum uric acid is associated with cardiac diastolic dysfunction among women with preserved ejection fraction

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