Jordhani Mikel, Cafka Majlinda, Seiti Joana, Barrios Vivencio
Internal Medicine Department, Korça Regional Hospital, 7001 Korça, Albania.
Cardiovascular Diseases Department, UHC "Mother Teresa", 1000 Tirana, Albania.
J Clin Med. 2023 Jul 31;12(15):5034. doi: 10.3390/jcm12155034.
Uric acid serves as a marker for cardiovascular risk and is often linked to inflammation and oxidative stress. There is evidence suggesting an association between uric acid and atrial fibrillation (AF), including its severity and occurrence of crises, as well as its involvement in cardiovascular mechanisms. The objective of this study was to assess the correlation between hyperuricemia and echocardiographic features in patients with chronic AF lasting for more than 5 years. This case-control study involved 107 patients diagnosed with chronic non-valvular AF. Uric acid levels were measured in all patients, and they were divided into two groups: the first group consisted of 66 patients with hyperuricemia (>7.2 mg/dL), while the second group included 41 patients with normal uric acid levels. Echocardiography (TTE) was performed to evaluate each patient. Various clinical and echocardiographic parameters, such as left ventricle telediastolic (LVTDD) and telesystolic (LVTSD) diameters, left atrial diameter (LAD), aortic diameter (AoD), ejection fraction (EF), and pulmonary artery pressure (PAP), were analyzed. Binary logistic regression analysis revealed a statistically significant relationship between uric acid levels (>7.2 mg/dL) and LAD. For each unit increase in LAD, the probability of having hyperuricemia increased by 9% [odds ratio (OD): 0.91, 95% confidence interval (CI): 0.84-0.99]. A significant relationship was found between uric acid levels (>8 mg/dL) and LVESD ( = 0.045) as well as PAP ( = 0.006). For every unit increase in LVESD, the likelihood of having uric acid levels greater than 8 mg/dL increased by 22% [OD: 0.82, 95% CI: 0.67-0.99, b = -0.2]. Likewise, for each unit increase in PAP, the probability of having uric acid levels greater than 8 mg/dL was 9.4% [OD: 0.91, 95% CI: 0.86-0.97, b = -0.09]. This study demonstrates that hyperuricemia has a significant relationship with the development of atrial remodeling, with an important association observed between hyperuricemia and an increase in left atrial diameter. Hyperuricemia is also correlated with an enlargement of the left ventricle end-systolic diameter and pulmonary artery pressure, showing a possible influence that hyperuricemia might have also left ventricle morphology and right ventricle function.
尿酸是心血管风险的一个标志物,常与炎症和氧化应激相关。有证据表明尿酸与心房颤动(AF)之间存在关联,包括其严重程度、发作情况以及在心血管机制中的作用。本研究的目的是评估慢性房颤持续超过5年患者的高尿酸血症与超声心动图特征之间的相关性。 这项病例对照研究纳入了107例诊断为慢性非瓣膜性房颤的患者。测量了所有患者的尿酸水平,并将他们分为两组:第一组由66例高尿酸血症患者(>7.2mg/dL)组成,而第二组包括41例尿酸水平正常的患者。对每位患者进行了超声心动图检查(TTE)。分析了各种临床和超声心动图参数,如左心室舒张末期(LVTDD)和收缩末期(LVTSD)直径、左心房直径(LAD)、主动脉直径(AoD)、射血分数(EF)和肺动脉压(PAP)。 二元逻辑回归分析显示尿酸水平(>7.2mg/dL)与LAD之间存在统计学上的显著关系。LAD每增加一个单位,患高尿酸血症的概率增加9%[比值比(OD):0.91,95%置信区间(CI):0.84 - 0.99]。尿酸水平(>8mg/dL)与左心室收缩末期内径(LVESD)(P = 0.045)以及肺动脉压(P = 0.006)之间存在显著关系。LVESD每增加一个单位,尿酸水平大于8mg/dL的可能性增加22%[OD:0.82,95%CI:0.67 - 0.99,b = -0.2]。同样,PAP每增加一个单位,尿酸水平大于8mg/dL的概率为9.4%[OD:0.91,95%CI:0.86 - 0.97,b = -0.09]。 本研究表明,高尿酸血症与心房重构的发展有显著关系,高尿酸血症与左心房直径增加之间存在重要关联。高尿酸血症还与左心室收缩末期直径增大和肺动脉压相关,表明高尿酸血症可能对左心室形态和右心室功能也有影响。