Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jun;7(3):1031-1038.
doi: 10.1002/ehf2.12691. Epub 2020 Apr 6.

Serum uric acid level and subclinical left ventricular dysfunction: a community-based cohort study

Koki Nakanishi  1 , Masao Daimon  1   2 , Yuriko Yoshida  1 , Jumpei Ishiwata  1 , Naoko Sawada  1 , Megumi Hirokawa  1 , Hidehiro Kaneko  1 , Tomoko Nakao  1 , Yoshiko Mizuno  1 , Hiroyuki Morita  1 , Marco R Di Tullio  3 , Shunichi Homma  3 , Issei Komuro  1
Affiliations

Serum uric acid level and subclinical left ventricular dysfunction: a community-based cohort study

Koki Nakanishi et al. ESC Heart Fail. 2020 Jun.

Abstract

Aims: Although serum uric acid (SUA) level is correlated with oxidative stress and serves as a marker of poor prognosis in heart failure patients, its possible association with subclinical left ventricular (LV) dysfunction has not been evaluated. This study aimed to investigate the association between SUA and subclinical LV dysfunction in a sample of a general population without overt cardiac disease.

Methods and results: We examined 1175 participants who underwent extensive cardiovascular health check-up including laboratory tests and speckle-tracking echocardiography to assess LV global longitudinal strain (GLS). The association of SUA concentration, as a continuous variable and a categorical variable using quartiles, with the presence of abnormal LVGLS was assessed. Mean age was 62 ± 12 years, and 656 (56%) were male participants. Mean SUA was 5.6 ± 1.3 mg/dL (25th-75th percentile, 4.6-6.5 mg/dL). The prevalence of abnormal LVGLS (greater than -18.6%) was greatest in the upper quartile of SUA. In multivariable analysis, SUA as a continuous variable was significantly associated with abnormal LVGLS [adjusted odds ratio (OR), 1.26 per 1 mg/dL; P = 0.008] independent of traditional cardiovascular risk factors, pertinent laboratory parameters and echocardiographic measures, and medications. In the categorical analysis, the upper quartile of SUA was independently associated with abnormal LVGLS in a fully adjusted model (adjusted OR, 2.28 vs. lowest quartile; P = 0.020).

Conclusions: In a sample of the general population, an elevated SUA was independently associated with subclinical LV dysfunction. Assessment of LVGLS may add important prognostic information in individuals with elevated SUA, even in the absence of overt cardiac disease.

Keywords: Echocardiography; Global longitudinal strain; Primary prevention; Uric acid.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Scatter plots illustrating the association between SUA and LVGLS. LVGLS, left ventricular global longitudinal strain; SUA, serum uric acid.
Figure 2
Figure 2
Prevalence of abnormal GLS according to the serum uric acid level. GLS, global longitudinal strain.
Figure 3
Figure 3
Association of SUA quartiles with abnormal LVGLS.Reference: Quartile 1. Multivariable Model 1: adjusted for age and sex. Multivariable Model 2: adjusted for age, sex, hypertension, diabetes mellitus and BMI. Multivariable Model 3: adjusted as in Model 2 with further adjustment for laboratory parameters including fasting glucose, HDL cholesterol, eGFR and CRP. Multivariable Model 4: adjusted as in Model 3 with further adjustment for LV ejection fraction, LV mass index, and E/e′. Multivariable Model 5: adjusted as in Model 4 with further adjustment for diuretics use. BMI, body mass index; CI, confidence interval; CRP, C‐reactive protein; E, early diastolic transmitral flow velocity; e′, early diastolic mitral annular velocity; eGFR, estimated glomerular filtration rate; GLS, global longitudinal strain; HDL, high‐density lipoprotein; LV, left ventricle; SUA, serum uric acid.
See this image and copyright information in PMC

References

    1. Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R, de Ferranti SD, Ferguson JF, Fornage M, Gillespie C, Isasi CR, Jimenez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Lutsey PL, Mackey JS, Matchar DB, Matsushita K, Mussolino ME, Nasir K, O'Flaherty M, Palaniappan LP, Pandey A, Pandey DK, Reeves MJ, Ritchey MD, Rodriguez CJ, Roth GA, Rosamond WD, Sampson UKA, Satou GM, Shah SH, Spartano NL, Tirschwell DL, Tsao CW, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P, On behalf of the American Heart Association Council on Epidemiology , Prevention Statistics Committee and Stroke Statistics Subcommittee . Heart Disease and Stroke Statistics‐2018 Update: A Report From the American Heart Association. Circulation 2018; 137: e67–e492. - PubMed
    1. Leyva F, Anker S, Swan JW, Godsland IF, Wingrove CS, Chua TP, Stevenson JC, Coats AJ. Serum uric acid as an index of impaired oxidative metabolism in chronic heart failure. Eur Heart J 1997; 18: 858–865. - PubMed
    1. Leyva F, Anker SD, Godsland IF, Teixeira M, Hellewell PG, Kox WJ, Poole‐Wilson PA, Coats AJ. Uric acid in chronic heart failure: a marker of chronic inflammation. Eur Heart J 1998; 19: 1814–1822. - PubMed
    1. Anker SD, Doehner W, Rauchhaus M, Sharma R, Francis D, Knosalla C, Davos CH, Cicoira M, Shamim W, Kemp M, Segal R, Osterziel KJ, Leyva F, Hetzer R, Ponikowski P, Coats AJ. Uric acid and survival in chronic heart failure: validation and application in metabolic, functional, and hemodynamic staging. Circulation 2003; 107: 1991–1997. - PubMed
    1. Pascual‐Figal DA, Hurtado‐Martinez JA, Redondo B, Antolinos MJ, Ruiperez JA, Valdes M. Hyperuricaemia and long‐term outcome after hospital discharge in acute heart failure patients. Eur J Heart Fail 2007; 9: 518–524. - PubMed