Relation between serum uric acid and lower limb blood flow in patients with chronic heart failure.
OBJECTIVE
To determine whether lower limb blood flow is related to serum uric acid concentrations in patients with chronic heart failure, taking into account the hyperuricaemic effects of diuretic treatment and insulin resistance.


METHODS
Lower limb blood flow was measured at rest and after maximum exercise followed by a five minute period of ischaemia (maximum blood flow) using strain gauge venous occlusion plethysmography. All patients underwent a metabolic assessment, which included an intravenous glucose tolerance test (IVGTT)-to obtain an index of insulin sensitivity- and measurement of serum uric acid.


METHODS
University and hospital departments specialising in cardiology and metabolic medicine.


METHODS
22 patients with chronic heart failure.


RESULTS
Mean (SEM) resting and maximum blood flow values were 2.87 (0.23) and 24.00 (1.83) ml/100 ml/min, respectively. Patients in the upper tertile of serum uric acid had lower maximum blood flow than those in the lowest tertile (15.6 (2.2) v 31.0 (2.1) ml/100 ml/min, P = 0.003). Serum uric acid correlated with maximum blood flow (r = -0.86, P < 0.001), but not with resting blood flow. In stepwise regression analysis, uric acid emerged as the only predictor of maximum blood flow (standardised coefficient = -0.83 (P < 0.001), R2 = 0.68 (P < 0.001)), independently of diuretic dose, age, body mass index, plasma creatinine, fasting and IVGTT glucose and insulin, insulin sensitivity, maximum oxygen uptake and exercise time during the treadmill exercise test, and alcohol intake.


CONCLUSIONS
There is a strong inverse relation between serum uric acid concentrations and maximum leg blood flow in patients with chronic heart failure. Further studies are needed to determine whether serum uric acid can be used as an index of vascular function in cardiovascular diseases.
Anker
S D
SD
Department of Cardiac Medicine, Imperial College School of Medicine, National Heart and Lung Institute, London, United Kingdom.
Leyva
F
F
Poole-Wilson
P A
PA
Kox
W J
WJ
Stevenson
J C
JC
Coats
A J
AJ
D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D004232:Diuretics / Q000008:administration & dosage; D005080:Exercise Test; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007328:Insulin / Q000097:blood; D007866:Leg / Q000098:blood supply*; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D012044:Regression Analysis; D014527:Uric Acid / Q000097:blood*
D015415:Biomarkers; D001786:Blood Glucose; D004232:Diuretics; D007328:Insulin; D014527:Uric Acid; D010100:Oxygen