title: Uricaemia and ejection fraction in elderly heart failure outpatients.
abstract: BACKGROUND
  Preliminary data suggest that serum uric acid (SUA) could be involved in the prognosis of chronic heart failure (HF). The aim of our study was to test the relationship between SUA and left ventricular ejection fraction (EF%) in a cohort of elderly hypertensive outpatients with chronic HF.
  
  
  METHODS
  We consecutively enrolled 487 elderly outpatients (M = 59·8%; F = 40·2%; mean age: 72 ± 11 years old) affected by mild-to-moderate hypertensive and/or ischaemic HF, evaluating the relationship between SUA and EF%.
  
  
  RESULTS
  In an univariate analysis, SUA was inversely related with EF%: B = -4·392, 95% CI -5·427 to -3·357, P < 0·001. After adjustment for a large number of variables in a multivariate analysis, the value of EF% was best predicted by SUA (B = -3·005, 95% CI -4·386 to -1·623, P < 0·001), log brain natriuretic peptide (BNP: B = -2·341, 95% CI -3·137 to -1·248, P < 0·001) and mean arterial pressure (MAP: B = 0·241, 95% CI 0·047 to 0·435, P = 0·015). A separate analysis by estimated glomerular filtration rate (eGFR) levels confirmed the inverse relationship between SUA and EF% in patients with normal renal function. A separate analysis by sex confirmed that SUA and log BNP were significant strong predictors of EF% in men, but not in women where the best predictors were log BNP, MAP and body mass index. The predicting role of SUA was apparently independent of eGFR and use of diuretics.
  
  
  CONCLUSIONS
  Serum uric acid seems to be inversely related to EF% in male elderly patients with HF after adjustment for the several confounding factors. This observation supports a primary negative effect of SUA on left ventricular function that warrants further investigations.
authors.affiliation: Medical and Surgical Sciences Department, University of Bologna, Bologna, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Borghi
authors.forename: Eugenio R
authors.initials: ER
authors.lastname: Cosentino
authors.forename: Elisa R
authors.initials: ER
authors.lastname: Rinaldi
authors.forename: Arrigo F G
authors.initials: AF
authors.lastname: Cicero
mesh_terms: D000368:Aged; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D033461:Hyperuricemia / Q000150:complications* / Q000503:physiopathology; D008297:Male; D010045:Outpatients; D011446:Prospective Studies; D013318:Stroke Volume / Q000502:physiology; D014527:Uric Acid / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology
chemical_list: D014527:Uric Acid
keywords: Ejection fraction; elderly; heart failure; outpatients; serum uric acid