Correlation between Serum Uric Acid level and Left Ventricular Ejection Fraction in Patients with Congestive Heart Failure

Abstract

Background: One of the risk factors of congestive heart failure that still under investigations is hyperuricemia. It's still debatable whether it's an independent risk factor or it's just a consequence of other disorders associated with cardiovascular diseases like hypertension, diabetes and dyslipidemia. Objective: The aim of our study is to elucidate whether in patients with heart failure serum uric acid level correlated with left ventricular ejection fraction supporting the possibility that the detection of progressive hyperuricemia in these patients may be an indicator of deteriorating cardiac function. Methods: We conducted a prospective study that included 124 studied patients and 26 apparently healthy persons at Coronary care unit and Internal Medicine Department at Sohag University Hospitals. All studied populations were classified into four groups; v Group I patients being newly diagnosed heart failure, v Group II patients decompensated heart failure on regular treatment, v Group III patients decompensated heart failure but stopped their treatment from three months, v Group IV control group selected to our study healthy and  age-matched subjects from 30 to 70 years old . Then we studied the association between left ventricular ejection fraction, the severity of congestive heart failure and the serum uric acid levels and the well-known conventional risk factor that include age, sex, BMI, positive family history, smoking, hypertension, diabetes and dyslipidemia then through logistic regression analysis we tried to identify the independent predictors of coronary artery diseases. Results: The mean finding in our study is the significant higher mean ± SD serum uric acid levels in patients with congestive heart failure (8.43±2.95) versus apparently healthy persons (5.55±1.48) with P value = .02. When we adjusted the serum uric acid with others significant factors in the univariate analysis which were age, gender and smoking, serum uric acid was an independent risk factor P value = .04. Another interesting finding is significant correlation between serum uric acid level and the severity of congestive heart failure P value<0.001,correlation coefficient=.35, where, that high rates of serum uric acid levels were recorded in patients with severe congestive heart failure. The gold finding is significant correlation between serum uric acid level and left ventricular ejection fraction P value<0.001, correlation coefficient=.35, where, that high rates of serum uric acid levels were recorded in patients with reduced ejection fraction. According to ROC analysis a uric acid level of 8.45 mg/dl was found to be the most appropriate cut-off point with the sensitivitv 62% and the specificity 75%. Conclusion: Higher serum uric acid levels are significantly correlated with the severity of congestive heart failure and left ventricular ejection fraction, as follows, the mean finding in our study is the significant higher mean ± SD serum uric acid levels in patients with congestive heart failure (8.43±2.95) versus apparently healthy persons (5.55±1.48) with P value = .02. When we adjusted the serum uric acid with others significant factors in the univariate analysis which were age, gender and smoking, serum uric acid was an independent risk factor P value = .04.