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. 2000 Jul;84(1):53–58. doi: 10.1136/heart.84.1.53

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

H Oya 1, N Nagaya 1, T Satoh 1, F Sakamaki 1, S Kyotani 1, M Fujita 1, N Nakanishi 1, K Miyatake 1
PMCID: PMC1729410  PMID: 10862589

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.


Keywords: Eisenmenger syndrome; prognosis; uric acid; haemodynamics

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Figure 1  .

Figure 1  

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Serum uric acid in male and female adult patients with Eisenmenger syndrome compared with age matched control subjects. Values are means, error bars = SEM. *p < 0.0001 v control.

Figure 2  .

Figure 2  

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Serum uric acid concentration in adult patients with Eisenmenger syndrome according to NYHA functional class. Values are means, error bars = SEM. Scheffé's multiple comparison test: *p = 0.0103 v controls; §p < 0.0001 v controls; †p < 0.0001 v NYHA class II; ‡p < 0.0001 v NYHA class III.

Figure 3  .

Figure 3  

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Relation between the serum uric acid concentration and mean pulmonary arterial pressure (mPAP, left panel), cardiac index (CI, middle panel), and total pulmonary resistance index (TPRI, right panel) in adult patients with Eisenmenger syndrome.

Figure 4  .

Figure 4  

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Kaplan-Meier analysis of cumulative survival rates in patients with Eisenmenger syndrome according to the median serum uric acid concentration. Log-rank test: p = 0.0014 in male patients; p = 0.0034 in female patients.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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