TY - JOUR
T1 - Uric acid in advanced heart failure
T2 - relation to central haemodynamics and outcome
AU - Deis, Tania
AU - Rossing, Kasper
AU - Ersbøll, Mads Kristian
AU - Wolsk, Emil
AU - Gustafsson, Finn
N1 - © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/11
Y1 - 2022/11
N2 - OBJECTIVE: The role of hyperuricaemia as a prognostic maker has been established in chronic heart failure (HF) but limited information on the association between plasma uric acid (UA) levels and central haemodynamic measurements is available.METHODS: A retrospective study on patients with advanced HF referred for right heart catherisation. Regression analyses were constructed to investigate the association between UA and haemodynamic variables. Cox models were created to investigate if UA was a significant predictor of adverse outcome where log1.1(UA) was used to estimate the effect on outcome associated with a 10% increase in UA levels.RESULTS: A total of 228 patients were included (77% males, age 49±12 years, mean left ventricular ejection fraction (LVEF) of 17%±8%). Median UA was 0.48 (0.39-0.61) mmol/L. UA level was associated to pulmonary capillary wedge pressure (PCWP) and cardiac index (CI) in univariable (both p<0.001) and multivariable regression analysis (p<0.004 and p=0.025 for PCWP and CI). When constructing multivariable Cox models including PCWP, CI, central venous pressure, age, estimated glomerular filtration rate (eGFR), use of loop diuretics and LVEF, log1.1(UA) independently predicted the combined endpoint (left ventricular assist device, total artificial heart implantation, heart transplantation or all-cause mortality) (hazard ratio (HR): 1.10 (1.03-1.17), p=0.004) as well as all-cause mortality (HR: 1.15 (1.06-1.25), p=0.001).CONCLUSIONS: Elevated UA is associated with greater haemodynamic impairment in advanced HF. In adjusted Cox models (age, eGFR, LVEF and haemodynamics), UA predicts the combined endpoint and all-cause mortality in long-term follow-up.
AB - OBJECTIVE: The role of hyperuricaemia as a prognostic maker has been established in chronic heart failure (HF) but limited information on the association between plasma uric acid (UA) levels and central haemodynamic measurements is available.METHODS: A retrospective study on patients with advanced HF referred for right heart catherisation. Regression analyses were constructed to investigate the association between UA and haemodynamic variables. Cox models were created to investigate if UA was a significant predictor of adverse outcome where log1.1(UA) was used to estimate the effect on outcome associated with a 10% increase in UA levels.RESULTS: A total of 228 patients were included (77% males, age 49±12 years, mean left ventricular ejection fraction (LVEF) of 17%±8%). Median UA was 0.48 (0.39-0.61) mmol/L. UA level was associated to pulmonary capillary wedge pressure (PCWP) and cardiac index (CI) in univariable (both p<0.001) and multivariable regression analysis (p<0.004 and p=0.025 for PCWP and CI). When constructing multivariable Cox models including PCWP, CI, central venous pressure, age, estimated glomerular filtration rate (eGFR), use of loop diuretics and LVEF, log1.1(UA) independently predicted the combined endpoint (left ventricular assist device, total artificial heart implantation, heart transplantation or all-cause mortality) (hazard ratio (HR): 1.10 (1.03-1.17), p=0.004) as well as all-cause mortality (HR: 1.15 (1.06-1.25), p=0.001).CONCLUSIONS: Elevated UA is associated with greater haemodynamic impairment in advanced HF. In adjusted Cox models (age, eGFR, LVEF and haemodynamics), UA predicts the combined endpoint and all-cause mortality in long-term follow-up.
KW - Male
KW - Humans
KW - Adult
KW - Middle Aged
KW - Female
KW - Uric Acid
KW - Stroke Volume
KW - Ventricular Function, Left
KW - Retrospective Studies
KW - Heart Failure/diagnosis
KW - Hemodynamics
UR - http://www.scopus.com/inward/record.url?scp=85143322151&partnerID=8YFLogxK
U2 - 10.1136/openhrt-2022-002092
DO - 10.1136/openhrt-2022-002092
M3 - Journal article
C2 - 36428082
SN - 2053-3624
VL - 9
JO - Open Heart
JF - Open Heart
IS - 2
M1 - e002092
ER -