title: Gout, not hyperuricemia alone, impairs left ventricular diastolic function.
abstract: BACKGROUND
  Gout is a common metabolic disorder characterized by hyperuricemia and chronic inflammation. Previous studies show that hyperuricemia accelerates the occurrence and worsening of cardiovascular disease due to LV remodeling. However, it is still unclear whether hyperuricemia is the sole contributor to organic heart remodeling in patients with gout. In addition, there is a paucity of data regarding the association between LV diastolic function and gout. The objective of this study was to investigate the effects of gout on LV diastolic function.
  
  
  METHODS
  A total of 173 patients were divided into tertiles based on the following serum uric acid (UA) levels: (1) serum UA ≤ 6.5 mg/dL (n = 54), (2) serum UA >6.5 to ≤8.5 mg/dL (n = 59), and (3) serum UA > 8.5 mg/dL (n = 60).Patients underwent a comprehensive Doppler-echocardiography examination to evaluate LV volume, systolic and diastolic function, and left atrial (LA) volume.
  
  
  RESULTS
  LV diastolic parameters, including diastolic peak early transmitral flow velocity (E), late transmitral flow velocity (A), E/A, peak early diastolic mitral annular velocity (Em), late diastolic annular velocity (Am), Em/Am, E/Em, maximal LA volume index (LAVi) and prevalence of moderate to severe LV diastolic dysfunction were not significantly different between the three groups. Among the population being studied, 108 individuals received a gout diagnosis. Gout patients had greater LV end-systolic dimensions (27.08 ± 4.38 mm, p = 0.006), higher LV mass index (107.18 ± 29.51 g/m2, p < 0.001), higher E/Em (10.07 ± 2.91, p = 0.008), and larger maximal LAVi (16.96 ± 7.39 mL/m2, p < 0.001) than patients without gout. The prevalence of moderate to severe LV diastolic dysfunction was higher in patients with gout (23%, p = 0.02).
  
  
  CONCLUSIONS
  Gout, not hyperuricemia alone, is associated with LV diastolic dysfunction and LA volume enlargement.
authors.affiliation: Division of Allergy and Immunology and Rheumatology, Chang Gung Memorial Hospital, Chiayi, Taiwan. jingchilin@gmail.com.|Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan. jingchilin@gmail.com.
authors.forename: Jing-Chi
authors.initials: JC
authors.lastname: Lin
authors.affiliation: Division of Nephrology, Chang Gung Memorial Hospital, Chiayi, Taiwan. linchunliang825@gmail.com.|Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan. linchunliang825@gmail.com.
authors.forename: Chun-Liang
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Division of Cardiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. chenmien@ms76.hinet.net.
authors.forename: Mien-Cheng
authors.initials: MC
authors.lastname: Chen
authors.affiliation: Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan. peyjiumc@mail.cgu.edu.tw.
authors.forename: Pey-Jium
authors.initials: PJ
authors.lastname: Chang
authors.affiliation: Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan. cst1234567@yahoo.com.tw.
authors.forename: Shih-Tai
authors.initials: ST
authors.lastname: Chang
authors.affiliation: Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan. cmchung02@hotmail.com.
authors.forename: Chang-Min
authors.initials: CM
authors.lastname: Chung
authors.affiliation: Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan. pankuoli64@gmail.com.|Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan. pankuoli64@gmail.com.
authors.forename: Kuo-Li
authors.initials: KL
authors.lastname: Pan
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003971:Diastole; D005260:Female; D006073:Gout / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006801:Humans; D033461:Hyperuricemia / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014463:Ultrasonography; D014527:Uric Acid / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology*
chemical_list: D015415:Biomarkers; D014527:Uric Acid