Hyperuricemia in patients with chronic atrial fibrillation

Abstract

Uric acid is a cardiovascular risk marker, often associated with inflammation & oxidative stress. There is evidence that associate it with atrial fibrillation (AF), its severity and crisis and showing its association with mechanisms of heart. The aim of this study was to evaluate the relationship between hyperuricemia & echocardiogaphic features in patients with chronic AF for more than 5 years. This was a case-control study which included 107 patients with chronic non-valvular AF. Uricemia was measured in all patients and they were divided into 2 groups: the first consisted in 66 patients with hyperuricemia (> 7.2 mg/dL) and the second in 41 patients with normal uricemia. Every patient was evaluated through echocardiography (TTE). All clinical data (age, disease duration, sex), echocardiographic parameters left ventricle telediastolic (LVTDD) and telesystolic (LVTSD) diameter, left atrial diameter (LAD), aortic diameter (AoD), ejection fraction (EF) and pulmonary pressure (PAP) were analysed. Through binary logistic regression, in backwards conditional method, it results a casual relationship statistically significant between uricemia (7.2 mg/dL) and LAD: for every elevation of LAD with 1 unit, the probability to have hyperuricemia increases by 9% [OD: 0.91, 95% CI: 0.84–0.99]. It exists a significant casual relation between uricemia (> 8 mg/dL) and TSLVD ( P = 0.045) and PAP ( P = 0.006). For every elevation of TSLVD with 1 unit, the chances of having a uricemia > 8 mg/dL increase with 22% [OD: 0.82, 95% CI: 0.67–0.99, b = −0.2]. For every elevation of PAP with 1 unit, the probability of having a uricemia greater than > 8 mg/dL is 9.4% [OD: 0.91, 95% CI: 0.86–0.97, b = −0.09]. In this study, it resulted that hyperuricemia is an important factor in the development of atrial remodelling, associated casually with an increase in left atrial diameter. Hyperuricemia is related with a greater left ventricle telesystolic diameter and pulmonary artery pressure.