Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Department of Internal Medicine, Ospedale Policlinico S.Orsola-Malpighi, Via Albertoni 15, 40138, Bologna, Italy.
Heart Fail Rev. 2020 Jan;25(1):43-51. doi: 10.1007/s10741-019-09869-z.
Uric acid, the metabolic mediator of gout and urate renal stones, is associated with increased cardiovascular risk burden. Hyperuricemia is an old emerging metabolic disorder, and interaction among uric acid and cardiovascular diseases has been clearly described. Several illness including hypertension, myocardial infarction, metabolic syndrome, and heart failure, are related with uric acid levels increase. In this review, we will discuss the pathophysiology of hyperuricemia and describe the biological plausibility for this metabolite to participate in the pathogenesis of cardiovascular disorders. In particular, we will focus on the implications of hyperuricemia in the onset and progression of heart failure, paying special attention to the pathophysiology and the possible clinical implications. We will conclude by discussing the effects of lowering plasma uric acid concentration on the prognosis of heart failure by reviewing most of available data on the different classes of drugs directly or indirectly involved in the hyperuricemia management.
尿酸是痛风和尿酸肾结石的代谢介质，与心血管风险负担增加有关。高尿酸血症是一种新兴的代谢紊乱，尿酸与心血管疾病之间的相互作用已被清楚描述。包括高血压、心肌梗死、代谢综合征和心力衰竭在内的几种疾病与尿酸水平升高有关。在这篇综述中，我们将讨论高尿酸血症的病理生理学，并描述这种代谢物参与心血管疾病发病机制的生物学合理性。特别是，我们将重点讨论高尿酸血症在心衰发生和进展中的意义，特别关注病理生理学和可能的临床意义。最后，我们将通过回顾不同类别药物在高尿酸血症管理中直接或间接涉及的大多数可用数据，讨论降低血浆尿酸浓度对心力衰竭预后的影响。
