title: Relationship of hyperuricemia with mortality in heart failure patients with preserved ejection fraction.
abstract: Serum uric acid is a predictor of cardiovascular mortality in heart failure with reduced ejection fraction. However, the impact of uric acid on heart failure with preserved ejection fraction (HFpEF) remains unclear. Here, we investigated the association between hyperuricemia and mortality in HFpEF patients. Consecutive 424 patients, who were admitted to our hospital for decompensated heart failure and diagnosed as having HFpEF, were divided into two groups based on presence of hyperuricemia (serum uric acid ≥7 mg/dl or taking antihyperuricemic agents). We compared patient characteristics, echocardiographic data, cardio-ankle vascular index, and cardiopulmonary exercise test findings between the two groups and prospectively followed cardiac and all-cause mortality. Compared with the non-hyperuricemia group (n = 170), the hyperuricemia group (n = 254) had a higher prevalence of hypertension (P = 0.013), diabetes mellitus (P = 0.01), dyslipidemia (P = 0.038), atrial fibrillation (P = 0.001), and use of diuretics (P < 0.001). Cardio-ankle vascular index (8.7 vs. 7.5, P < 0.001) and V̇e/V̇co2 slope (34.9 vs. 31.9, P = 0.02) were also higher. In addition, peak V̇o2 (14.9 vs. 17.9 ml·kg(-1)·min(-1), P < 0.001) was lower. In the follow-up period (mean 897 days), cardiac and all-cause mortalities were significantly higher in those with hyperuricemia (P = 0.006 and P = 0.004, respectively). In the multivariable Cox proportional hazard analyses after adjustment for several confounding factors including chronic kidney disease and use of diuretics, hyperuricemia was an independent predictor of all-cause mortality (hazard ratio 1.98, 95% confidence interval 1.036-3.793, P = 0.039). Hyperuricemia is associated with arterial stiffness, impaired exercise capacity, and high mortality in HFpEF.
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Takeshi
authors: T
authors: Shimizu
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and Department of Advanced Cardiac Therapeutics, Fukushima Medical University, Fukushima, Japan yoshihis@fmu.ac.jp.
authors: Akiomi
authors: A
authors: Yoshihisa
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Yuki
authors: Y
authors: Kanno
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Mai
authors: M
authors: Takiguchi
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Akihiko
authors: A
authors: Sato
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Shunsuke
authors: S
authors: Miura
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Yuichi
authors: Y
authors: Nakamura
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Hiroyuki
authors: H
authors: Yamauchi
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Takashi
authors: T
authors: Owada
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Satoshi
authors: S
authors: Abe
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Takamasa
authors: T
authors: Sato
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and Department of Advanced Cardiac Therapeutics, Fukushima Medical University, Fukushima, Japan.
authors: Satoshi
authors: S
authors: Suzuki
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Masayoshi
authors: M
authors: Oikawa
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Takayoshi
authors: T
authors: Yamaki
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Koichi
authors: K
authors: Sugimoto
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Hiroyuki
authors: H
authors: Kunii
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Kazuhiko
authors: K
authors: Nakazato
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Hitoshi
authors: H
authors: Suzuki
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and.
authors: Shu-ichi
authors: S
authors: Saitoh
authors: Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan; and Department of Advanced Cardiac Therapeutics, Fukushima Medical University, Fukushima, Japan.
authors: Yasuchika
authors: Y
authors: Takeishi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology; D016022:Case-Control Studies; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D004232:Diuretics / Q000627:therapeutic use; D050171:Dyslipidemias / Q000453:epidemiology; D004452:Echocardiography; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D033461:Hyperuricemia / Q000097:blood* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D016016:Proportional Hazards Models; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D012307:Risk Factors; D013318:Stroke Volume; D059289:Vascular Stiffness
chemical_list: D004232:Diuretics
keywords: arterial stiffness; diastolic dysfunction; exercise capacity; heart failure; uric acid