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Uricaemia and ejection fraction in elderly heart failure outpatients
Author(s) -
Borghi Claudio,
Cosentino Eugenio R.,
Rinaldi Elisa R.,
Cicero Arrigo F.G.
Publication year - 2014
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12273
Subject(s) - ejection fraction , medicine , heart failure , cardiology , renal function , natriuretic peptide , univariate analysis , brain natriuretic peptide , body mass index , uric acid , blood pressure , multivariate analysis
Background Preliminary data suggest that serum uric acid ( SUA ) could be involved in the prognosis of chronic heart failure ( HF ). The aim of our study was to test the relationship between SUA and left ventricular ejection fraction ( EF %) in a cohort of elderly hypertensive outpatients with chronic HF . Design We consecutively enrolled 487 elderly outpatients ( M = 59·8%; F = 40·2%; mean age: 72 ± 11 years old) affected by mild‐to‐moderate hypertensive and/or ischaemic HF , evaluating the relationship between SUA and EF %. Results In an univariate analysis, SUA was inversely related with EF %: B = −4·392, 95% CI −5·427 to −3·357, P < 0·001. After adjustment for a large number of variables in a multivariate analysis, the value of EF % was best predicted by SUA ( B = −3·005, 95% CI −4·386 to −1·623, P < 0·001), log brain natriuretic peptide ( BNP : B = −2·341, 95% CI −3·137 to −1·248, P < 0·001) and mean arterial pressure ( MAP : B = 0·241, 95% CI 0·047 to 0·435, P = 0·015). A separate analysis by estimated glomerular filtration rate (e GFR ) levels confirmed the inverse relationship between SUA and EF % in patients with normal renal function. A separate analysis by sex confirmed that SUA and log BNP were significant strong predictors of EF % in men, but not in women where the best predictors were log BNP , MAP and body mass index. The predicting role of SUA was apparently independent of e GFR and use of diuretics. Conclusion Serum uric acid seems to be inversely related to EF % in male elderly patients with HF after adjustment for the several confounding factors. This observation supports a primary negative effect of SUA on left ventricular function that warrants further investigations.