Gout, not hyperuricemia alone, impairs left ventricular diastolic function

Primary tabs

SCIENCE
Gout, not hyperuricemia alone, impairs left ventricular diastolic function
Key Take-Away: 

This study depicts that gout impacts left ventricular diastolic dysfunction and left auricular volume enlargement. In the gout patients, the left ventricular diastolic remodeling may be a predictor of adverse cardiac events.

Gout is a common metabolic disorder characterized by hyperuricemia and chronic inflammation.

ABSTRACT: 
Background: 

Gout is a common metabolic disorder characterized by hyperuricemia and chronic inflammation.

Previous studies show that hyperuricemia accelerates the occurrence and worsening of cardiovascular disease due to LV remodeling. However, it is still unclear whether hyperuricemia is the sole contributor to organic heart remodeling in patients with gout. In addition, there is a paucity of data regarding the association between LV diastolic function and gout. The objective of this study was to investigate the effects of gout on LV diastolic function.

Methods: 

A total of 173 patients were divided into tertiles based on the following serum uric acid (UA) levels: 1) serum UA ≤ 6.5 mg/dL (n = 54), 2) serum UA >6.5 to ≤8.5 mg/dL (n = 59), and 3) serum UA > 8.5 mg/dL (n = 60).

Patients underwent a comprehensive Doppler-echocardiography examination to evaluate LV volume, systolic and diastolic function, and left atrial (LA) volume.

Results: 

LV diastolic parameters, including diastolic peak early transmitral flow velocity (E), late transmitral flow velocity (A), E/A, peak early diastolic mitral annular velocity (Em), late diastolic annular velocity (Am), Em/Am, E/Em, maximal LA volume index (LAVi) and prevalence of moderate to severe LV diastolic dysfunction were not significantly different between the three groups.

Among the population being studied, 108 individuals received a gout diagnosis. Gout patients had greater LV end-systolic dimensions (27.08 ± 4.38 mm, p = 0.006), higher LV mass index (107.18 ± 29.51 g/m2, p < 0.001), higher E/Em (10.07 ± 2.91, p = 0.008), and larger maximal LAVi (16.96 ± 7.39 mL/m2, p < 0.001) than patients without gout. The prevalence of moderate to severe LV diastolic dysfunction was higher in patients with gout (23%, p = 0.02).

Conclusion: 

Gout, not hyperuricemia alone, is associated with LV diastolic dysfunction and LA volume enlargement.

Arthritis Res Ther. 2015 Nov 14;17(1):323
Log in or register to post comments