Haemodynamic correlates and prognostic significance of serum uric acid in adult patients with Eisenmenger syndrome.
OBJECTIVE
To assess haemodynamic correlates and prognostic significance of serum uric acid in adult patients with Eisenmenger syndrome.


METHODS
Retrospective observational study.


METHODS
Tertiary referral centre.


METHODS
94 adult patients with Eisenmenger syndrome who were diagnosed between September 1982 and July 1998.


METHODS
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.
Oya
H
H
Department of Internal Medicine, National Cardiovascular Centre, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan.
Nagaya
N
N
Satoh
T
T
Sakamaki
F
F
Kyotani
S
S
Fujita
M
M
Nakanishi
N
N
Miyatake
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D004541:Eisenmenger Complex / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014527:Uric Acid / Q000097:blood*
D015415:Biomarkers; D014527:Uric Acid