Seyyedi Seyyed Reza, Malekmohammad Majid, Chitsazan Mandana, Behzadnia Neda, Sadr Makan, Hashemian Seyed Mohammadreza, Sharif-Kashani Babak
Lung Transplantation Research Center, Department of Cardiology, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Tracheal Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Tanaffos. 2017 Jun;16(4):283-288.
Right heart catheterization is the gold standard test for diagnosis and clinical assessment of the patients with pulmonary hypertension (PH). In recent years, the usefulness of cheaper and non-invasive tests in the follow-up of PH patients is being studied. The aim of the present study was to evaluate the relationship between serum uric acid level and severity of pulmonary hypertension in PH patients.
In a cross-sectional study, serum uric acid was measured in 110 patients with PH (63 women; mean age [±SD] was 52.83±17.88 years). Pulmonary arterial pressure and severity of right ventricular dysfunction were assessed using RHC and echocardiography, respectively.
Serum uric acid was higher in PH patients with severe RV dysfunction, compared to mild and moderate dysfunction (7.8mg/dl [IQR: 5.8-9.2] in severe dysfunction, versus 4.7 mg/dl [3.87-5.82] in mild dysfunction and 5 mg/dl [3.5-6.95] in moderate dysfunction. Serum uric acid was significantly correlated with pulmonary artery systolic pressure (r=0.51, P<0.001). Serum uric acid level also had a significant positive correlation with the World Health Organization functional class of the patients (r=0.49, P<0.001). Serum uric acid level greater than 5.7 mg/dl was found to be the most sensitive and specific points for predicting severe RV dysfunction in PH patients (sensitivity 76.6%, specificity 71.4%; AUC=0.79, P<0.001) .
Serum uric acid is correlated with the severity of symptoms and RV dysfunction in patients with pulmonary hypertension. Further studies are recommended with larger sample size in this regard.
右心导管检查是诊断和临床评估肺动脉高压（PH）患者的金标准测试。近年来，正在研究价格更低且非侵入性测试在PH患者随访中的有用性。本研究的目的是评估PH患者血清尿酸水平与肺动脉高压严重程度之间的关系。
在一项横断面研究中，对110例PH患者（63例女性；平均年龄[±标准差]为52.83±17.88岁）测量血清尿酸。分别使用右心导管检查和超声心动图评估肺动脉压力和右心室功能障碍的严重程度。
与轻度和中度功能障碍的PH患者相比，重度右心室功能障碍的PH患者血清尿酸更高（重度功能障碍时为7.8mg/dl[四分位间距：5.8 - 9.2]，轻度功能障碍时为4.7mg/dl[3.87 - 5.82]，中度功能障碍时为5mg/dl[3.5 - 6.95]）。血清尿酸与肺动脉收缩压显著相关（r = 0.51，P < 0.001）。血清尿酸水平与患者的世界卫生组织功能分级也有显著正相关（r = 0.49，P < 0.001）。发现血清尿酸水平大于5.7mg/dl是预测PH患者重度右心室功能障碍的最敏感和特异的点（敏感性76.6%，特异性71.4%；曲线下面积 = 0.79，P < 0.001）。
血清尿酸与肺动脉高压患者的症状严重程度和右心室功能障碍相关。建议在这方面进行更大样本量的进一步研究。
