Cardiovascular medicine
Haemodynamic correlates and prognostic significance of serum uric
acid in adult patients with Eisenmenger syndrome
H Oyaa, N Nagayaa, T Satoha, F Sakamakia, S Kyotania, M Fujitab, N Nakanishia, K Miyatakea
a Department of
Internal Medicine, National Cardiovascular Centre, 5-7-1 Fujishirodai,
Suita, Osaka 565-8565, Japan, b College of Medical
Technology, Kyoto University, Kyoto, Japan
Correspondence to: Dr Nagaya email: hooya{at}hsp.ncvc.go.jp
Accepted 15 March 2000
OBJECTIVE
To assess haemodynamic correlates and
prognostic significance of serum uric acid in adult patients with
Eisenmenger syndrome.
DESIGNRetrospective observational study.
SETTINGTertiary referral centre.
PATIENTS94 adult patients with Eisenmenger syndrome who
were diagnosed between September 1982 and July 1998.
MAIN OUTCOME MEASURESSerum uric acid was measured in all
patients, together with clinical and haemodynamic variables related to mortality.
RESULTSSerum 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).
CONCLUSIONSSerum 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
© 2000 by Heart
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