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Heart. 2000 Jul;84(1):53-8. doi: 10.1136/heart.84.1.53.

Haemodynamic correlates and prognostic significance of serum uric acid in adult patients with Eisenmenger syndrome.

Heart (British Cardiac Society)

H Oya, N Nagaya, T Satoh, F Sakamaki, S Kyotani, M Fujita, N Nakanishi, K Miyatake

Affiliations

  1. Department of Internal Medicine, National Cardiovascular Centre, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan.

PMID: 10862589 PMCID: PMC1729410 DOI: 10.1136/heart.84.1.53

Abstract

OBJECTIVE: To assess haemodynamic correlates and prognostic significance of serum uric acid in adult patients with Eisenmenger syndrome.

DESIGN: Retrospective observational study.

SETTING: Tertiary referral centre.

PATIENTS: 94 adult patients with Eisenmenger syndrome who were diagnosed between September 1982 and July 1998.

MAIN OUTCOME MEASURES: Serum uric acid was measured in all patients, together with clinical and haemodynamic variables related to mortality.

RESULTS: Serum uric acid was raised in patients with Eisenmenger syndrome compared with age and sex matched control subjects (7.0 v 4.7 mg/dl, p < 0.0001) and increased in proportion to the severity of New York Heart Association functional class. Serum uric acid was positively correlated with mean pulmonary arterial pressure (r = 0.30, p = 0.0052) and total pulmonary resistance index (r = 0.55, p < 0.0001), and negatively correlated with cardiac index (r = -0.50, p < 0.0001). During a mean follow up period of 97 months, 38 patients died of cardiopulmonary causes. Among various clinical, echocardiographic, and laboratory variables, serum uric acid remained predictive in multivariate analysis. Kaplan-Meier survival curves based on median serum uric acid showed that patients with high values had a significantly worse survival rate than those with low values (log-lank test: p = 0.0014 in male patients, p = 0.0034 in female patients).

CONCLUSIONS: Serum uric acid increases in proportion to haemodynamic severity in adult patients with Eisenmenger syndrome and is independently associated with long term mortality.

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