scholarly journals Correlation Between Uric Acid and Atrial Electromechanical Coupling Interval in Heart Failure with Reduced Ejection Fraction

2020 ◽  
Vol 6 (1) ◽  
pp. 34-40
Author(s):  
Rosa Syafitri ◽  
Pintoko Tedjokusumo ◽  
M. Rizki Akbar
Keyword(s):  
Heart Failure ◽  
Uric Acid ◽  
Ejection Fraction ◽  
Electromechanical Coupling ◽  
P Wave ◽  
Doppler Imaging ◽  
Conduction Delay ◽  
Time Interval ◽  
Reduced Ejection Fraction ◽  
Coupling Interval

Background: Chronic Heart Failure (CHF) can lead to atrial and structural remodeling that result in non-homogenous impulse propagation and inter and intra-atrial conduction delay. Prolongation of interval of Atrial ElectroMechanical Coupling (AEMC) in CHF patient was related to atrial electromechanical remodeling and Atrial Fibrillation (AF) risk. Hyperuricemia found in CHF played a role in the pathophysiology of AF through neuro-hormonal activation, oxidative stress, inflammation and ionic channel dysfunction. This study aimed to investigate the association between uric acid and AEMCinterval in CHF with reduced ejection fraction.Methods: This study was a cross sectional study. Subject were CHF patients with reduced ejection fraction and sinus rhythm who visited cardiology clinic Dr. Hasan Sadikin Bandung between July - September 2018. Blood sampling for uric acid was performed in the morning after fasting 10-12 hours. AEMC interval was measured by echocardiography Tissue Doppler Imaging (TDI) as time interval from onset of P wave in surface electrocardiography to onset of A wave from TDI in lateral atrial wall called lateral PA interval. Statistical analysis was done by linear regression analysis to control confounding variables.Results: This study involved 51 CHF patients with reduced ejection fraction (< 40%) with median age 62 (27 – 81) year, 92% have history of myocardial infarction or coronary revascularization, 16% have diabetes mellitus, 51% have hypertension, and eGFR of 60.9 + 22.1. Mean uric acid was 8.0 + 2.2 mg/dL and mean lateral PA interval was 67.4 + 19.2 ms. Uric acid was significantly associated with lateral PA interval (R : 0.665, adjusted R2 0.407, P < 0.001) after controlling the confounding variables: systolic blood pressure and diastolic function.Conclusion: Uric acid significantly correlated positively with AEMC interval in CHF patients with reduced ejection fraction.

scholarly journals INFLUENCE OF URIC ACID LEVEL IN PATIENTS HOSPITALIZED FOR HEART FAILURE WITH REDUCED EJECTION FRACTION: INSIGHTS FROM THE EVEREST TRIAL

2013 ◽  
Vol 61 (10) ◽  
pp. E618
Author(s):  
Stephen John Greene ◽  
Muthiah Vaduganathan ◽  
Andrew Ambrosy ◽  
Marvin Konstam ◽  
Haris Subacius ◽  
...  
Keyword(s):  
Heart Failure ◽  
Uric Acid ◽  
Ejection Fraction ◽  
Uric Acid Level ◽  
Acid Level ◽  
Reduced Ejection Fraction

scholarly journals Relationship of hyperuricemia with mortality in heart failure patients with preserved ejection fraction

2015 ◽  
Vol 309 (7) ◽  
pp. H1123-H1129 ◽  
Author(s):  
Takeshi Shimizu ◽  
Akiomi Yoshihisa ◽  
Yuki Kanno ◽  
Mai Takiguchi ◽  
Akihiko Sato ◽  
...  
Keyword(s):  
Heart Failure ◽  
Uric Acid ◽  
Ejection Fraction ◽  
Serum Uric Acid ◽  
Decompensated Heart Failure ◽  
Cardiopulmonary Exercise Test ◽  
Preserved Ejection Fraction ◽  
Reduced Ejection Fraction ◽  
All Cause Mortality ◽  
The Impact

Serum uric acid is a predictor of cardiovascular mortality in heart failure with reduced ejection fraction. However, the impact of uric acid on heart failure with preserved ejection fraction (HFpEF) remains unclear. Here, we investigated the association between hyperuricemia and mortality in HFpEF patients. Consecutive 424 patients, who were admitted to our hospital for decompensated heart failure and diagnosed as having HFpEF, were divided into two groups based on presence of hyperuricemia (serum uric acid ≥7 mg/dl or taking antihyperuricemic agents). We compared patient characteristics, echocardiographic data, cardio-ankle vascular index, and cardiopulmonary exercise test findings between the two groups and prospectively followed cardiac and all-cause mortality. Compared with the non-hyperuricemia group ( n = 170), the hyperuricemia group ( n = 254) had a higher prevalence of hypertension ( P = 0.013), diabetes mellitus ( P = 0.01), dyslipidemia ( P = 0.038), atrial fibrillation ( P = 0.001), and use of diuretics ( P < 0.001). Cardio-ankle vascular index (8.7 vs. 7.5, P < 0.001) and V̇e/V̇co2 slope (34.9 vs. 31.9, P = 0.02) were also higher. In addition, peak V̇o2 (14.9 vs. 17.9 ml·kg−1·min−1, P < 0.001) was lower. In the follow-up period (mean 897 days), cardiac and all-cause mortalities were significantly higher in those with hyperuricemia ( P = 0.006 and P = 0.004, respectively). In the multivariable Cox proportional hazard analyses after adjustment for several confounding factors including chronic kidney disease and use of diuretics, hyperuricemia was an independent predictor of all-cause mortality (hazard ratio 1.98, 95% confidence interval 1.036–3.793, P = 0.039). Hyperuricemia is associated with arterial stiffness, impaired exercise capacity, and high mortality in HFpEF.

scholarly journals P1544 Independent prognostic significance of non invasive left atrial stiffness in outpatients with heart failure and reduced ejection fraction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
I Bytyci ◽  
N Riccardo ◽  
A Bajraktari ◽  
M Mazzola ◽  
G Bajraktari ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Left Atrial ◽  
Prognostic Significance ◽  
Doppler Imaging ◽  
Volume Index ◽  
Cardiac Events ◽  
Roc Curve Analysis ◽  
Reduced Ejection Fraction ◽  
Non Invasive

Abstract Background and Aim Left atrial (LA) stiffness is an important marker of cardiac pump function, especially in patients with heart failure (HF) and preserved ejection fraction (HFpEF). The aim of this study was to evaluate the relationship between LA stiffness and cardiac events (CE) in HF patients with reduced ejection fraction (HFrEF). Methods This study included 136 consecutive HFrEF outpatients (mean age: 65 ± 11 years). A complete conventional and tissue Doppler imaging study was performed. The LA dimension and function were measured. Non invasive LA stiffness was calculated with the following formula: LA stiffness = E/e’ratio/LA strain. The cardiac events were HF hospitalization and cardiac death. Results During a median follow up of 55 ± 37 months, 51 patients had CE, they had higher NYHA functional class (p = 0.001), higher LV end-diastolic dimension (p = 0.001), higher LV end-systolic dimension (p = 0.04), lower EF (p &lt; 0.001), higher E/A ratio (p = 0.01) and reduced TAPSE (p = 0.001) compared with patients without CE. LA volume index was higher (p = 0.001), LA strain was reduced and LA stiffness was increased in patients with CE compared to those without CE (p = 0.0001, p &lt; 0.0001, respectively). LA stiffness exhibited the closest relationship with E/e’ ratio (r = 0.67, p &lt; 0.001). Survival analyses showed that LA stiffness [HR: 4.026 (1.300–12.468), p = 0.001] was the most powerful independent predictor of cardiac events[C1] . On ROC curve analysis, a LA stiffness &lt; 0.82% was 81% sensitive and 73% specific (AUC 0.81, p &lt; 0.001) in predicting clinical events (Figure 1). Conclusion In this cohort of outpatients with HFrEF, LA stiffness proved the most important predictor of clinical outcome. [C1] Abstract P1544 Figure.

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