title: The effects of gout on left atrial volume remodelling: a prospective echocardiographic study.
abstract: OBJECTIVE
  The aim of the present study was to investigate the effect of gout on left ventricular (LV) diastolic function and left atrial volume (LAV).
  
  
  METHODS
  A total of 173 patients were divided into four groups: control (n = 35), asymptomatic hyperuricaemia (n = 30), gouty arthritis without tophi (n = 58) and gouty tophi (n = 50). Patients underwent a comprehensive Doppler echocardiography examination to evaluate LV volume, systolic and diastolic function and LAV and function.
  
  
  RESULTS
  Serum uric acid levels were not significantly different in the asymptomatic hyperuricaemia, gouty arthritis without tophi and gouty tophi groups. However, the ratio of the transmitral and myocardial peak early diastolic velocities (E/e') and LAV index (LAVi) progressively increased from the control group to the gouty tophi group. The tophi group had significantly higher E/e' [10.5 (s.d. 3.2) vs 8.6 (s.d. 2.1), P = 0.008] and larger maximal, pre-contraction and minimal LAVi [29.6 ml/m(2) (s.d. 9.9) vs 20.1 ml/m(2) (s.d. 4.8); 19.1 ml/m(2) (s.d. 8.5) vs 11.5 ml/m(2) (s.d. 3.4); 9.6 ml/m(2) (s.d. 4.2) vs 6.1 ml/m(2) (s.d. 2.2); all P < 0.001] than the control group. By binary logistic analysis, maximal LAVi was an independent predictor for the development of tophi in gout patients, with an odds ratio of 1.068 (95% CI 1.02, 1.118; P = 0.005).
  
  
  CONCLUSIONS
  The severity of gout had a significant effect on LV diastolic dysfunction and LA enlargement in gout patients. Additionally, a high maximal LAVi predicted the development of tophi and may be a predictor of adverse cardiovascular events related to LA and LV remodelling in this clinical setting.
authors.affiliation: Division of Cardiology, Chang Gung Memorial Hospital, No. 6, West Chia-Pu Road, Putz, Chiayi Hsien, Taiwan 613, Republic of China. pankuoli64@gmail.com.
authors.forename: Kuo-Li
authors.initials: KL
authors.lastname: Pan
authors.forename: Jing-Chi
authors.initials: JC
authors.lastname: Lin
authors.forename: Chun-Liang
authors.initials: CL
authors.lastname: Lin
authors.forename: Mien-Cheng
authors.initials: MC
authors.lastname: Chen
authors.forename: Pey-Jium
authors.initials: PJ
authors.lastname: Chang
authors.forename: Ju-Feng
authors.initials: JF
authors.lastname: Hsiao
authors.forename: Shih-Tai
authors.initials: ST
authors.lastname: Chang
authors.forename: Chang-Min
authors.initials: CM
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D015210:Arthritis, Gouty / Q000150:complications*; D064752:Atrial Remodeling; D002306:Cardiac Volume; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D005260:Female; D006073:Gout / Q000150:complications*; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D033461:Hyperuricemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014527:Uric Acid / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology; D020257:Ventricular Remodeling
chemical_list: D014527:Uric Acid
keywords: diastolic dysfunction; gout; left atrial volume; uric acid