2B.05

Objective: Elevated levels of serum uric acid have been associated in population studies with an increased risk of cardiovascular disease. Increasing evidence suggests that serum uric acid may be a useful marker for metabolic, hemodynamic, and functional staging in heart failure (HF) and a valid predictor of survival in HF patients. The aim of our study was to investigate the association between hyperuricemia and subclinical myocardial dysfunction. Design and method: The study included 64 hypertensive patients with hyperuricemia (n = 31) or without hyperuricemia, (n = 33) and control group of 33 age and sex matched healthy subjects. Patients with high variability of the uric acid measurements from the first and second visits were excluded. Left atrial volume index (LAVI), left ventricular mass index (LVMI), left ventricular dimensions and volume inexes (LVEDV/BSA and LVESV/BSA) and EF were estimated by echocardiography. We measured coresponding velocities from tissue Doppler at the level of the septal mitral annulus (Em, Am, Sm), including isovolumic contraction velocity (IVCv) and E/Em. Global longitudinal strain (GLS) was derived from two-dimensional speckle-tracking. Results: Close correlations were found between GLS and E/Em (r = 0.449;p = 0.0004) and IVCv (r = -0.390; p = 0.0008). Levels of E/Em (7.7 ± 1.5 vs 10.3 ± 1.7 vs 14.6 ± 1.8; p = 0.0007), LVEDV/BSA (91.0 ± 15.3 vs 103.1 ± 23.5 vs 105.8 ± 24.7; p = 0.015), LVESV/BSA (34.5 ± 9.3 vs 42.3 ± 10.2 vs 46.1 ± 15.4; p = 0.001), LVMI (104.2 ± 17.3 vs 112.7 ± 20.5 vs 123.9 ± ± 28.3; p = 0.003) and LAVI (34.9 ± 9.7 vs 40.2 ± 11.8 vs 47.0 ± 12.0; p = 0.0002) progressively increased from the normal group through group of hypertensive patients without hyperuricemia and group with hyperuricemia. Significantly different value of GLS (-22.4 ± 5.0 vs -19.6 ± 4.0 vs -16.6 ± 4.9; p = 0.0002) was obtained between groups too, but with progressively decrease from the normal group through group of hypertensive patients without hyperuricemia and group with hyperuricemia. Conclusions: According to this observation, uric acid could be considered a new parameter for cardiac remodeling and subclinical myocardial dysfunction in hypertensive patients. This suggests that uric acid may aid in the identification of patients at high risk for development of HF who need preventive treatment. The question of whether uric acid is only a marker rather than a causal factor in the pathogenesis of HF remains.