Serum level of uric acid, partly secreted from the failing heart, is a prognostic marker in patients with congestive heart failure.
BACKGROUND
A recent study suggested that xanthine oxidase is activated in congestive heart failure (CHF). However, whether uric acid (UA) is secreted from the failing heart remains unknown, so it is currently unclear whether serum UA can provide prognostic information independent of brain natriuretic peptide (BNP).


RESULTS
Serum UA was measured in the aortic root (AO) and the coronary sinus (CS) of 74 patients with CHF. The serum UA level was significantly higher in the CS than in the AO. The transcardiac gradient of UA (CS-AO) increased with the severity of CHF, inversely correlated with left ventricular ejection fraction (LVEF) and positively correlated with left ventricular end-diastolic volume index. The plasma levels of norepinephrine, BNP, UA, and LVEF were monitored prospectively in 150 CHF patients for a mean follow-up of 3 years. High plasma levels of UA (p<0.001) and BNP (p<0.001) were shown by multivariate stepwise analysis to be independent predictors of mortality.


CONCLUSIONS
High plasma UA level, partly secreted from the failing heart, is a prognostic predictor independent of BNP in patients with CHF. Monitoring a combination of BNP and UA may be useful for the management of patients with CHF.
Sakai
Hiroshi
H
Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.
Tsutamoto
Takayoshi
T
Tsutsui
Takashi
T
Tanaka
Toshinari
T
Ishikawa
Chitose
C
Horie
Minoru
M
D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003627:Data Interpretation, Statistical; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009206:Myocardium / Q000378:metabolism*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009638:Norepinephrine / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D014527:Uric Acid / Q000097:blood*; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D014527:Uric Acid; D009638:Norepinephrine