Abstract
BackgroundHyperuricemia is frequently present in patients with heart failure. Many pathological conditions, such as tissue ischemia, renal function impairment, cardiac function impairment, metabolic syndrome, and inflammatory status, may impact uric acid (UA) metabolism. This study was to assess their potential relations to UA metabolism in heart failure.MethodsWe retrospectively assessed clinical characteristics, echocardiological, renal, metabolic and inflammatory variables selected on the basis of previous evidence of their involvement in cardiovascular diseases and UA metabolism in a large cohort of randomly selected adults with congestive heart failure (n = 553). By clustering of indices, those variables were explored using factor analysis.ResultsIn factor analysis, serum uric acid (SUA) formed part of a principal cluster of renal functional variables which included serum creatinine (SCr) and blood urea nitrogen (BUN). Univariate correlation coefficients between variables of patients with congestive heart failure showed that the strongest correlations for SUA were with BUN (r = 0.48, P < 0.001) and SCr (r = 0.47, P < 0.001).ConclusionsThere was an inverse relationship between SUA levels and measures of renal function in patients with congestive heart failure. The strong correlation between SUA and SCr and BUN levels suggests that elevated SUA concentrations reflect an impairment of renal function in heart failure.
Highlights
Hyperuricemia is frequently present in patients with heart failure
We reviewed the medical record of 553 patients with congestive heart failure from our heart center between January 2005, and March 2010
There was little impact on the results of factor analysis. This is the first study to analyze the interrelationships between serum uric acid (SUA), clinical status, cardiac function, renal function, metabolic variables, and leukocyte profile
Summary
We reviewed the medical record of 553 patients with congestive heart failure from our heart center between January 2005, and March 2010. Renal, metabolic variables, and inflammatory markers (such as leukocyte profile) were selected on the basis of previous evidence of their involvement in heart failure and/or UA metabolism in cardiovascular diseases.[10,11,12,13,14,15,16,17,18,19,20] The following variables were included in the analysis: body mass index (BMI), New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF), arterial pressure, fasting glucose (FG), lipid profile (including total cholesterol level (TCL), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG), serum creatinine (SCr), blood urea nitrogen (BUN), leukocyte profile (including neutrophils and monocytes), and diuretic dose. We used three alternatives (i.e., exclude cases listwise, exclude cases pairwise, or replace with mean) to handle the missing values, and compared their impact on the final results
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